Individual
KENNETH R. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7701 W ASPERA BLVD, GLENDALE, AZ 85308-7947
(623) 465-6060
(623) 242-5833
Mailing address
7701 W ASPERA BLVD STE 201, GLENDALE, AZ 85308-7947
(623) 465-6060
(623) 242-5833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
64419
AZ
Other
Enumeration date
08/30/2006
Last updated
10/01/2025
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