Individual
SCOTT M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 W CENTRE AVE, BRONSON OB GYN ASSOCIATES, PORTAGE, MI 49024-4666
(269) 327-2211
(269) 327-0273
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301068138
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235131137
BCBSM - BLH
MI
05
—
1649250242
—
MI
05
—
4681190
—
MI
05
—
4770173
—
MI
Enumeration date
01/19/2006
Last updated
11/27/2023
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