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Individual

ERIK JON PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
516 DELAWARE ST SE, PWB SIXTH FLOOR, CLINIC 6A, MINNEAPOLIS, MN 55455-0356
(612) 625-8690
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(612) 625-8690

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45093
MN
207RR0500X
Rheumatology Physician
Primary
45093
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
090883500
MN
01
1031720
PREFERRED ONE
MN
01
142412
UCARE
MN
01
1686374
ARAZ
MN
01
244A6PE
BLUE CROSS BLUE SHIELD
MN
01
32-00003
MEDICA PRIMARY
MN
01
32-00093
MEDICA CHOICE
MN
05
34260300
WI
01
HP39455
HEALTH PARTNERS
MN
Enumeration date
10/24/2006
Last updated
10/26/2012
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