Petersen, Michael S

Petersen, Michael S is an sole proprietor health care provider with primary practice located at 2020 Sutter Pl Suite 104, Davis CA 95616-6213. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Petersen, Michael S can be contacted via phone (530) 750-5900.

Contact Information

Primary practice address
2020 Sutter Pl Suite 104 Davis CA 95616-6213
Phone: (530) 750-5900
Fax: (530) 750-5901
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X A49302 California

Profile Details

NPI number 1467428656
LBN Legal business name Petersen, Michael S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 27th, 2006
Last updated Jul 8th, 2015 - 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 1467428656 NPPES
California Other 200018048 RAILROAD MEDICARE INDIVIDUAL PTAN

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