Individual
DR. JOHN WILLIAM PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
893 MAIN STREET, EAST MACHIAS, ME 04963-0893
(207) 255-0102
(207) 255-4645
Mailing address
21 COURT STREET, MACHIAS, ME 04654
(207) 255-4253
(207) 255-4539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
008942
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124490099
—
ME
Enumeration date
01/19/2007
Last updated
03/09/2010
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