Petersen-Goldspiel, Jennifer

Petersen-Goldspiel, Jennifer is an individual health care provider with primary practice located at 1312 W. Arch Haven Avenue , Bloomington IN 47403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Petersen-Goldspiel, Jennifer can be contacted via phone (812) 676-4144.

Contact Information

Primary practice address
1312 W. Arch Haven Avenue Bloomington IN 47403
Phone: (812) 676-4144
Fax: (812) 339-8344
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01059768A Indiana

Profile Details

NPI number 1104821974
LBN Legal business name Petersen-Goldspiel, Jennifer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated May 17th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104821974 NPPES
Indiana MEDICAID 200495150

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