Individual
DR. RYAN JON PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG OR 97471, ROSEBURG, OR 97471-1281
(314) 750-3965
Mailing address
2700 NW STEWART PKWY, ROSEBURG OR 97471, ROSEBURG, OR 97471-1281
(314) 750-3965
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
BB4745785-2005017258
MO
207P00000X
Emergency Medicine Physician
Primary
MD125955
OR
Other
Enumeration date
10/11/2006
Last updated
05/09/2025
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