Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 4301023747 | MI |
NPI | 1023282647 |
---|---|
Provider Name | Dr. Edwin Peter Peterson |
First Address | Ann Arbor, MI 48105 |
Second Address | Ann Arbor, MI 48105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 15/04/2008 |