Individual
ROBERT LYNN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5380
(314) 268-4141
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5380
(314) 268-4141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2014011778
MO
2080P0202X
Pediatric Cardiology Physician
Primary
2014011778
MO
Other
Enumeration date
04/01/2011
Last updated
10/03/2025
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