Petersen, John Peter

Petersen, John Peter is an sole proprietor health care provider with primary practice located at 3555 10Th Court Indian River Regional Cancer Center, Irmc, Vero Beach FL 32960-4862. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Petersen, John Peter can be contacted via phone (772) 794-3333.

Contact Information

Primary practice address
3555 10Th Court Indian River Regional Cancer Center, Irmc Vero Beach FL 32960-4862
Phone: (772) 794-3333
Fax: (772) 569-6949
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X ME 64848 Florida

Profile Details

NPI number 1790786895
LBN Legal business name Petersen, John Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2005
Last updated Mar 24th, 2020 - about 6 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 1790786895 NPPES
Other 920004346 MEDICARE RR
MEDICAID 374792100 MEDICARE RR

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