Individual
JOHN E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13123 E 16TH AVE, DEPARTMENT OF PSYCHIATRY, AURORA, CO 80045-7106
(720) 777-4715
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
26170
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08155020
—
CO
Enumeration date
08/21/2006
Last updated
03/17/2014
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