Timothy K. Peterson PA-C

NPI 1992887376 - Physician Assistant - 363A00000X

NPI Details
NPI 1992887376
Gender Male
Enumeration Date 10/19/2006
Last Updated 05/27/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
449 BROWNELL ST SE
GRAND RAPIDS MI, 49548-7310, US
Phone (616) 827-0974
Fax
Business Location
449 BROWNELL ST SE
GRAND RAPIDS MI, 49548-7310, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Michigan
License Number 5601001733
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According to our database, Timothy K. Peterson PA-C NPI is 1992887376, taxonomy code is 363A00000X and license number is 5601001733, license state is located at Michigan. Timothy K. Peterson PA-C physically located at 449 Brownell St Se, Grand Rapids MI, 49548-7310. NPI Number Timothy K. Peterson PA-C has the Individual type.

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1992887376 NPI number is provided on an as is basis without warranty of any kind. 1992887376 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy K. Peterson PA-C are for informational purposes only.