Individual
MR. MICHAEL D PETERIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4550 E BELL RD, SUITE 170, PHOENIX, AZ 85032-9306
(480) 443-8400
(480) 443-8697
Mailing address
4550 E BELL RD, SUITE 170, PHOENIX, AZ 85032-9306
(480) 443-8400
(480) 443-8697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00155600
NJ
363A00000X
Physician Assistant
Primary
3397
AZ
363AM0700X
Medical Physician Assistant
3397
AZ
Other
Enumeration date
07/15/2006
Last updated
04/16/2013
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