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Individual

JOSEPH MICHAEL PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
222 N 5TH ST, SUITE 205, MARTINS FERRY, OH 43935-1582
(740) 633-6573
(740) 633-6574
Mailing address
2000 EOFF ST, WHEELING, WV 26003-3823
(304) 234-8663
(304) 234-8960

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
13832
WV
208600000X
Surgery Physician
Primary
35078810
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0124384000
WV
05
2262108
OH
Enumeration date
01/11/2007
Last updated
05/27/2015
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