Peterson, Brian G
Peterson, Brian G is an individual health care provider with primary practice located at 10012 Kennerly Rd Suite 305, Saint Louis MO 63128-2197. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Peterson, Brian G can be contacted via phone (314) 525-4325.Contact Information
Primary practice address
10012 Kennerly Rd Suite 305
Saint Louis MO 63128-2197
Phone: (314) 525-4325
Fax: (314) 525-4365
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 2006019887 | Missouri |
Profile Details
| NPI number | 1356359376 |
|---|---|
| LBN Legal business name | Peterson, Brian G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2006 |
| Last updated | May 24th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356359376 | NPPES |
| Missouri | MEDICAID | 1356329376 |
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