Individual
PETER DOUGLAS VAN PATTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Mailing address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
38758
MN
207W00000X
Ophthalmology Physician
Primary
38758
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150257300
—
MN
05
—
396319500
—
MN
Enumeration date
07/17/2006
Last updated
05/10/2011
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