Peterson, Mark

Peterson, Mark is an individual health care provider with primary practice located at 111 Great Teays Blvd Ste 101 , Scott Depot WV 25560-9548. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Peterson, Mark can be contacted via phone (304) 757-8803.

Contact Information

Primary practice address
111 Great Teays Blvd Ste 101 Scott Depot WV 25560-9548
Phone: (304) 757-8803
Fax: (304) 757-6904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 30925 West Virginia
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 30925 West Virginia

Profile Details

NPI number 1477043842
LBN Legal business name Peterson, Mark
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2018
Last updated May 30th, 2024 - about 2 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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