Peterson, Dirk

Peterson, Dirk is an individual health care provider with primary practice located at 650 Del Prado Blvd S Ste 100 , Cape Coral FL 33990. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Peterson, Dirk can be contacted via phone (239) 424-2060.

Contact Information

Primary practice address
650 Del Prado Blvd S Ste 100 Cape Coral FL 33990
Phone: (239) 424-2060
Fax: (239) 424-2061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME69232 Florida
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X ME69232 Florida

Profile Details

NPI number 1770570475
LBN Legal business name Peterson, Dirk
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Apr 25th, 2023 - about 3 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 1770570475 NPPES
Florida MEDICAID 256918300

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