Jerry R Petersen, MD

NPI #1467451344 in Spring Park, Minnesota

Provider Information

NPI Number: 1467451344
Entity Type: Individual
Name: Jerry R Petersen, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Jul 21, 2005
Last Updated: May 12, 2008

Practice Location

Address: 4695 SHORELINE DR
City: Spring Park
State: Minnesota
ZIP Code: 55384-9715
Phone: (952) 442-7890

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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Organizations

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