Individual
MR. RICHARD M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11 JOHN STARK HWY, NEWPORT, NH 03773-1807
(603) 863-4100
(603) 863-8800
Mailing address
11 JOHN STARK HWY, NEWPORT, NH 03773-1807
(603) 863-4100
(603) 863-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0455
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0AP1868
—
VT
05
—
30332330
—
NH
Enumeration date
06/26/2006
Last updated
04/20/2018
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