Individual
DR. MARCO ANTONIO PETERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.
Contact information
Practice address
1101 W UNIVERSITY DR, 2 SOUTH, ROCHESTER, MI 48307-1863
(786) 340-3804
Mailing address
1910 ROSELAND BLVD, TYLER, TX 75701-4246
(903) 533-0644
(903) 533-0441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301500521
MI
207Q00000X
Family Medicine Physician
Primary
S3042
TX
Other
Enumeration date
04/06/2016
Last updated
10/09/2022
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