Individual
DR. SHAUN N PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 E GRANT RD, TUCSON, AZ 85712-2805
(520) 784-6200
(520) 784-6445
Mailing address
PO BOX 31630, TUCSON, AZ 85751-1630
(520) 784-6200
(520) 784-6109
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
65052
AZ
207X00000X
Orthopaedic Surgery Physician
A97027
CA
207X00000X
Orthopaedic Surgery Physician
MD10803
HI
207X00000X
Orthopaedic Surgery Physician
MD60145041
WA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD60145041
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A970270
MEDI-CAL
CA
05
—
100566
—
AZ
Enumeration date
01/19/2006
Last updated
10/10/2025
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