| Doctor Name: | ANIBAL PETERSON-CAMACHO |
| NPI Number: | 1194715573 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 6570 |
| Business Practice Address: | Cms Dr E Koppisch Barbasa Esq Sicilia 404 San Juan, PR - 00926 |
| Business Phone Number: | 4877588840 |
| Business Fax Number: | 7877589962 |
| Mailing Address: | Calle 15 H 13, Jaidines De Caparra BAYAMON |
| State: | PR |
| Postal Code: | 00959 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 6570 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |