Peterson, Douglas

Peterson, Douglas is an individual health care provider with primary practice located at 1630 Anderson Ave , Buffalo MN 55313-2945. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Peterson, Douglas can be contacted via phone (800) 876-7171.

Contact Information

Primary practice address
1630 Anderson Ave Buffalo MN 55313-2945
Phone: (800) 876-7171
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 22930 Minnesota

Profile Details

NPI number 1710962832
LBN Legal business name Peterson, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jul 9th, 2007 - about 19 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 1710962832 NPPES
Minnesota Other 92M48PE BCBS
Minnesota MEDICAID 92M48PE BCBS
Minnesota MEDICAID 146290300 BCBS

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