Individual
DR. BRAD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2827 FORT MISSOULA ROAD, COMMUNITY MEDICAL CENTER, DEPT. OF PATHOLOGY, MISSOULA, MT 59804-7408
(406) 327-4330
(406) 327-4515
Mailing address
PO BOX 30382, BILLINGS, MT 59107-0382
(888) 843-8475
(314) 849-6395
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
9730
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0036584
—
MT
Enumeration date
05/18/2006
Last updated
09/14/2016
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