Individual
DR. GREGORY JAMES PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 PEBBLE LAKE RD, SUITE 500, FERGUS FALLS, MN 56537-3800
(218) 736-1884
(218) 736-1880
Mailing address
1505 PEBBLE LAKE RD, SUITE 500, FERGUS FALLS, MN 56537-3800
(218) 736-1884
(218) 736-1880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
020301
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
436777400
—
MN
Enumeration date
12/06/2006
Last updated
09/09/2009
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