Organization
DENA PETERSEN, M.D. P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENA E PETERSEN M.D. (OWNER)
(520) 293-1415
Entity
Organization
Contact information
Practice address
4574 N 1ST AVE STE 180, TUCSON, AZ 85718-5699
(520) 293-1415
(520) 293-1434
Mailing address
4574 N 1ST AVE STE 180, TUCSON, AZ 85718-5699
(520) 293-1415
(520) 293-1434
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100823
UHC
—
01
—
10296
PREPCARE
—
01
—
9778467
CIGNA
—
01
—
AZ0817530
BLUE CROSS
AZ
01
—
Z20625
MEDICARE ID
AZ
Enumeration date
11/19/2008
Last updated
12/02/2008
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