Individual
JOHN WILLIAM PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 S.W. ARCHER ROAD, GAINESVILLE, FL 32608-1197
(352) 376-1611
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-9065
(352) 392-3606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
122247
NC
207RC0000X
Cardiovascular Disease Physician
Primary
ME105059
FL
Other
Enumeration date
06/11/2007
Last updated
08/23/2023
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