Individual
DR. CHAD ALLAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
980 W IRONWOOD DR, STE. 104, COEUR D ALENE, ID 83814-2668
(208) 667-0621
(208) 664-1709
Mailing address
980 W IRONWOOD DR, STE. 104, COEUR D ALENE, ID 83814-2668
(208) 667-0621
(208) 664-1709
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M-10619
ID
Other
Enumeration date
05/15/2007
Last updated
05/31/2012
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