Individual
MITCHELL DAVID PETERKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 W 140TH ST UNIT 201, BURNSVILLE, MN 55337-4833
(952) 808-3000
(952) 808-3001
Mailing address
1000 W 140TH ST UNIT 201, BURNSVILLE, MN 55337-4833
(952) 808-3000
(952) 808-3001
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
13022
MN
363AS0400X
Surgical Physician Assistant
PA.0004490
CO
Other
Enumeration date
11/17/2015
Last updated
06/05/2019
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