Individual
DR. RICHARD ALVIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3448
(763) 302-4081
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
47556
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01N64PE
BCBS OF MN
MN
01
—
0500505
MEDICA
MN
01
—
1043493
PREFERRED ONE
MN
01
—
132846C029
UCARE
MN
01
—
2350907
AAMERICA'S PPO
MN
05
—
236934600
—
MN
05
—
34640200
—
WI
01
—
HP51315
HEALTHPARTNERS
MN
01
—
P00225563
RAILROAD MEDICARE
MN
Enumeration date
06/12/2006
Last updated
02/24/2021
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