Individual
DIANE M PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10010 KENNERLY RD FL 4, SAINT LOUIS, MO 63128-2106
(314) 525-6072
(314) 525-1387
Mailing address
10010 KENNERLY RD FL 4, SAINT LOUIS, MO 63128-2106
(314) 525-6072
(314) 525-1387
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2002025841
MO
Other
Enumeration date
07/10/2006
Last updated
12/01/2022
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