Dr. Dustin J Petersen
Surgeon Trauma Surgeon Surgical Critical Care and 2 more
11141 Parkview Plaza Dr Ste 305
Fort Wayne
, Indiana 46845-1715
Dr. Dustin J Petersen
Surgeon Trauma Surgeon Surgical Critical Care and 2 more
11141 Parkview Plaza Dr Ste 305
Fort Wayne
, Indiana 46845-1715
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About
Features
Specialties
- Surgeon
- Surgical Critical Care
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Dr. Dustin J Petersen
- 11109 Parkview Plaza Dr # 117
- Fort Wayne, IN
- Zip : 46845-1701
- Phone :
Second Address
- Dr. Dustin J Petersen
- 11141 Parkview Plaza Dr Ste 305
- Fort Wayne, IN
- Zip : 46845-1715
- Fax : (260) 266-8935
- Phone : (260) 266-8900
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Is Dr. Dustin J Petersen a sole practitioner?
Is Dr. Dustin J Petersen accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 01073898A | IN |
| N | 208600000X | Surgeon | 01073898A | IN |
| N | 208200000X | Surgeon | 26510 | WV |
| N | 208600000X | Surgeon | 26510 | WV |
| Y | 2086S0102X | Surgical Critical Care | 01073898A | IN |
| N | 2086S0102X | Surgical Critical Care | 26510 | WV |
| N | 2086S0127X | Trauma Surgeon | 01073898A | IN |
| N | 2086S0127X | Trauma Surgeon | 26510 | WV |
National Provider Identifier
| NPI | 1265661383 |
|---|---|
| Provider Name | Dr. Dustin J Petersen |
| First Address | Fort Wayne, IN 46845-1701 |
| Second Address | Fort Wayne, IN 46845-1715 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/07/2009 |
| Last Update Date | 07/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.