Peterson, Mark Steven
Peterson, Mark Steven is an individual health care provider with primary practice located at 677 N Wilmot Rd , Tucson AZ 85711-2701. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Peterson, Mark Steven can be contacted via phone (520) 795-2889.Contact Information
Primary practice address
677 N Wilmot Rd
Tucson AZ 85711-2701
Phone: (520) 795-2889
Fax: (520) 795-6321
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 23713 | Arizona |
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 23713 | Arizona |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 23713 | Arizona |
Profile Details
| NPI number | 1588635544 |
|---|---|
| LBN Legal business name | Peterson, Mark Steven |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Feb 27th, 2013 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588635544 | NPPES |
| Arizona | Other | 005472 | GROUP MEDICAID ID |
| Arizona | Other | 300129081 | GROUP MEDICAID ID |
| Arizona | MEDICAID | 645369 | GROUP MEDICAID ID |
| Arizona | Other | CS7943 | GROUP MEDICAID ID |
| Arizona | Other | ZWCBBM | GROUP MEDICAID ID |
| Arizona | Other | 1588635544 | GROUP MEDICAID ID |
| Arizona | Other | 1841261989 | GROUP MEDICAID ID |
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