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Individual

DR. CAROLINE E PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
7756 WASHINGTON VILLAGE DR STE 135, CENTERVILLE, OH 45459-3999
(937) 425-4137
(937) 425-4139
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8493

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34005030
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000227867
UNICARE
OH
01
0720366
UNITED HEALTH CARE
OH
05
0976243
OH
01
160058956
RAILROAD MEDICARE
OH
01
2917001
AETNA
OH
01
34005030P
MEDICAL LICENSE
OH
01
421534596078
CARESOURCE
OH
01
D0503006
HUMANA/CHOICECARE
OH
01
D0503007
HUMANA/CHOICECARE
OH
01
OC05510
NATIONWIDE
OH
Enumeration date
12/20/2005
Last updated
01/13/2025
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