Individual
MR. SCOTT D. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
33300 CLEVELAND CLINIC BLVD, MAIL CODE AVH4-143, AVON, OH 44011
(440) 695-5449
Mailing address
33300 CLEVELAND CLINIC BLVD, MAIL CODE AVH4-143, AVON, OH 44011
(440) 695-5449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02841
NC
363A00000X
Physician Assistant
Primary
50.002138
OH
363A00000X
Physician Assistant
85000637
IL
Other
Enumeration date
02/27/2006
Last updated
11/17/2016
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