Organization Name: | GEORGE D PETERSON MD PA |
NPI Number: | 1073750634 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEORGE D PETERSON (PHYSICIAN) |
Mailing Address: | 5450 Macdonald Ave Suite 12 Key West |
State: | FL US |
Postal Code: | 330405903 |
Phone Number: | 3052939555 |
Fax Number: | 3052939551 |
NPI Enumeration Date: | 01/19/2009 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME0065007 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |