Individual
BRUCE A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(612) 625-5411
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(612) 625-5411
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
20660
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100798
UCARE
MN
01
—
1009270
PREFERRED ONE
MN
01
—
2T174PE
BLUE CROSS BLUE SHIELD
MN
01
—
36-00273
MEDICA PRIMARY
MN
01
—
36-24612
MEDICA CHOICE
MN
01
—
768301
ARAZ
MN
05
—
990868400
—
MN
01
—
HP22238
HEALTH PARTNERS
MN
Enumeration date
10/24/2006
Last updated
10/26/2012
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