Peterson, Michael Scott
Peterson, Michael Scott is an individual health care provider with primary practice located at 1201 Broad Rock Blvd , Richmond VA 23249-0001. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Low Vision Rehabilitation is his primary health care specialty. Peterson, Michael Scott can be contacted via phone (804) 675-5000.Contact Information
Primary practice address
1201 Broad Rock Blvd
Richmond VA 23249-0001
Phone: (804) 675-5000
Fax: (804) 675-5908
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 7533 | Texas |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 4901004024 | Michigan |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 0618002288 | Virginia |
Profile Details
| NPI number | 1437177656 |
|---|---|
| LBN Legal business name | Peterson, Michael Scott |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Sep 24th, 2020 - about 4 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 | 1437177656 | NPPES |
| Michigan | MEDICAID | 4309851 |
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