| Doctor Name: | DIRK PETERSON |
| NPI Number: | 1770570475 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME006923269232 |
| Business Practice Address: | 1682 Ne Pine Island Rd Cape Coral, FL - 339091730 |
| Business Phone Number: | 2394241600 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2147, FORT MYERS |
| State: | FL |
| Postal Code: | 339022147 |
| Phone Number: | 2392421449 |
| Fax Number: | 2394241421 |
| NPI Enumeration Date: | 09/29/2005 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | ME006923269232 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |