Individual
TIM GERARD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 988-2300
(504) 988-7389
Mailing address
1430 TULANE AVE # TW22, NEW ORLEANS, LA 70112-2632
(504) 988-2300
(504) 988-7389
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
020904
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
020904
LA
Other
Enumeration date
08/15/2008
Last updated
02/24/2010
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