David S. Petersen, M.d.s.c.

NPI #1982900825 in Moline, Illinois

Provider Information

NPI Number: 1982900825
Entity Type: Organization
Organization Name: David S. Petersen, M.d.s.c.
Primary Specialty: Urology
Enumeration Date: Feb 9, 2011
Last Updated: Feb 9, 2011

Practice Location

Address: 2121 1ST STREET A
City: Moline
State: Illinois
ZIP Code: 61265-7745
Phone: (309) 764-9790

Authorized Official

Name: DR. DAVID S PETERSEN, M.D.
Title: PRESIDENT
Phone: (309) 764-9790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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