Individual
BRIAN WADE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3800 HOUMA BLVD, SUITE 205, METAIRIE, LA 70006-4182
(504) 885-7337
Mailing address
3800 HOUMA BLVD, SUITE 205, METAIRIE, LA 70006-4182
(504) 885-7337
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD.205229
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2008
Last updated
10/15/2013
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