Peterson, Calvin H

Peterson, Calvin H is an individual health care provider with primary practice located at 100 South St , Southbridge MA 01550-4051. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Peterson, Calvin H can be contacted via phone (508) 765-9771.

Contact Information

Primary practice address
100 South St Southbridge MA 01550-4051
Phone: (508) 765-9771
Fax: (508) 764-2448
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C500000139 Delaware
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1146 Massachusetts

Profile Details

NPI number 1508845421
LBN Legal business name Peterson, Calvin H
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Dec 29th, 2014 - about 11 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 1508845421 NPPES
Delaware MEDICAID 000867643

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