Petersen, Dustin J
Petersen, Dustin J is an individual health care provider with primary practice located at 11141 Parkview Plaza Dr Ste 305 , Fort Wayne IN 46845-1715. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Petersen, Dustin J can be contacted via phone (260) 266-8900.Contact Information
Primary practice address
11141 Parkview Plaza Dr Ste 305
Fort Wayne IN 46845-1715
Phone: (260) 266-8900
Fax: (260) 266-8935
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 26510 | West Virginia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01073898A | Indiana |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 26510 | West Virginia |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 26510 | West Virginia |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 01073898A | Indiana |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 01073898A | Indiana |
Profile Details
| NPI number | 1265661383 |
|---|---|
| LBN Legal business name | Petersen, Dustin J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2009 |
| Last updated | Oct 10th, 2022 - 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.
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