Peterson, Mark Steven
Peterson, Mark Steven is an individual health care provider with primary practice located at 925 Commercial St Se Ste 102 , Salem OR 97302-4173. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Peterson, Mark Steven can be contacted via phone (503) 561-7227.Contact Information
Primary practice address
925 Commercial St Se Ste 102
Salem OR 97302-4173
Phone: (503) 561-7227
Fax: (503) 671-8334
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | MD16135 | Oregon |
Profile Details
| NPI number | 1003980053 |
|---|---|
| LBN Legal business name | Peterson, Mark Steven |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Oct 7th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003980053 | NPPES |
| Oregon | MEDICAID | 010509 |
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