Individual
DR. JOHN M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, MD
Contact information
Practice address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Mailing address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036051289
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110028700
RR MEDICARE
IL
Enumeration date
01/26/2006
Last updated
06/11/2008
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