Individual
NICHOLAS D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE BOX 604, ROCHESTER, NY 14642-0001
(507) 244-1705
Mailing address
601 ELMWOOD AVE BOX 604, ROCHESTER, NY 14642-0001
(507) 244-1705
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
265131
NY
207L00000X
Anesthesiology Physician
50944
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/24/2007
Last updated
01/05/2023
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