Individual
GARY L PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 S DOBSON RD, MESA, AZ 85202
(480) 456-9500
(480) 820-7623
Mailing address
PO BOX 7127, PHOENIX, AZ 85011-7127
(480) 456-9500
(480) 820-7623
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10050
AZ
Other
Enumeration date
03/16/2006
Last updated
07/08/2007
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