| Doctor Name: | DR. CARL ROY PETERSON |
| NPI Number: | 1114151230 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., M.S. |
| License Number: | 35.091496 |
| Business Practice Address: | 8401 Market St Boardman, OH - 445126725 |
| Business Phone Number: | 3306297500 |
| Business Fax Number: | 3306297504 |
| Mailing Address: | Po Box 636988, CINCINNATI |
| State: | OH |
| Postal Code: | 452636988 |
| Phone Number: | 8889402722 |
| Fax Number: | 5136328898 |
| NPI Enumeration Date: | 05/04/2009 |
| NPI Last Update Date: | 10/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0001X |
| License Number: | 35.091496 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Radiation Oncology |
| Taxonomy Definition: | A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |