Petersen, Kathleen B

Petersen, Kathleen B is an individual health care provider with primary practice located at 5 Caldwell Rd , Augusta ME 04330-5739. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Petersen, Kathleen B can be contacted via phone (207) 623-1322.

Contact Information

Primary practice address
5 Caldwell Rd Augusta ME 04330-5739
Phone: (207) 623-1322
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 012473 Maine

Profile Details

NPI number 1487632675
LBN Legal business name Petersen, Kathleen B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated Feb 25th, 2014 - about 10 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 1487632675 NPPES
Maine MEDICAID 257240099
Maine Other 005243
Maine Other 1041118
Maine Other 6191075
Maine Other B86469

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