Petersen, John Peter
Petersen, John Peter is an sole proprietor health care provider with primary practice located at 3555 10Th Court Indian River Regional Cancer Center, Irmc, Vero Beach FL 32960-4862. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Petersen, John Peter can be contacted via phone (772) 794-3333.Contact Information
Primary practice address
3555 10Th Court Indian River Regional Cancer Center, Irmc
Vero Beach FL 32960-4862
Phone: (772) 794-3333
Fax: (772) 569-6949
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | ME 64848 | Florida |
Profile Details
| NPI number | 1790786895 |
|---|---|
| LBN Legal business name | Petersen, John Peter |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Mar 24th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790786895 | NPPES |
| Other | 920004346 | MEDICARE RR | |
| MEDICAID | 374792100 | MEDICARE RR |
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