Peterson, Michael Gene

Peterson, Michael Gene is an individual health care provider with primary practice located at 201 E. Nicollet Blvd. , Burnsville MN 55337. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Peterson, Michael Gene can be contacted via phone (612) 889-5480.

Contact Information

Primary practice address
201 E. Nicollet Blvd. Burnsville MN 55337
Phone: (612) 889-5480
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4301085530 Michigan
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 52328 Minnesota

Profile Details

NPI number 1609079094
LBN Legal business name Peterson, Michael Gene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2007
Last updated Feb 11th, 2010 - about 15 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 1609079094 NPPES
Minnesota MEDICAID 1609079094
Minnesota Other 52328
Minnesota Other 207P00000X

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