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Individual

MR. ROBERT CHARLES PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
GNP

Contact information

Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
(906) 779-3146
Mailing address
W5924 SPRINGVIEW DR, NORWAY, MI 49870-2282
(906) 563-8231
(906) 779-3146

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704219482
MI

Other

Enumeration date
07/31/2006
Last updated
07/08/2007
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