Individual
DR. MICHAEL ANDRE PETERKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101254872
VA
207L00000X
Anesthesiology Physician
017546
ME
207L00000X
Anesthesiology Physician
Primary
D0077726
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972706638
—
VA
01
—
P01323398
RAILROAD MEDICARE
VA
Enumeration date
06/08/2007
Last updated
06/10/2020
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