Individual
SCOTT PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3777 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-2630
(763) 421-7420
(763) 421-0730
Mailing address
3777 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-2630
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
5101019986
MI
Other
Enumeration date
01/04/2016
Last updated
03/17/2018
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