Peterson, Randolph K.

Peterson, Randolph K. is an individual health care provider with primary practice located at 6525 France Ave S Suite 200, Edina MN 55435-2148. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Peterson, Randolph K. can be contacted via phone (952) 927-6501.

Contact Information

Primary practice address
6525 France Ave S Suite 200 Edina MN 55435-2148
Phone: (952) 927-6501
Fax: (952) 653-1435
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 40788 Minnesota

Profile Details

NPI number 1053380204
LBN Legal business name Peterson, Randolph K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Nov 10th, 2015 - about 11 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 1053380204 NPPES
Minnesota Other 984811017049 PREFERRED ONE
Minnesota Other HP31830 PREFERRED ONE
Minnesota MEDICAID 881029000 PREFERRED ONE
Minnesota Other 220033481 PREFERRED ONE
Minnesota Other 525S5PE PREFERRED ONE
Minnesota Other 11-00306 PREFERRED ONE

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