Dr. John William Petersen
Neurology
12000 Elm Creek Blvd N Ste L70
Maple Grove
, Minnesota 55369-7167
(763) 420-4111
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About
Features
Language(s) Spoken
English
Ethnic Identity
White / Caucasian
Specialties
- Neurology
Languages spoken
- English
Location
First Address
- Dr. John William Petersen
- 12000 Elm Creek Blvd N Ste L70
- Maple Grove, MN
- Zip : 55369-7167
- Phone : (763) 420-4111
Second Address
- Dr. John William Petersen
- 12000 Elm Creek Blvd N Ste L70
- Maple Grove, MN
- Zip : 55369-7167
- Phone : (763) 420-4111
Reviews
FAQs
Where did Dr. John William Petersen attend graduate school?
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Where did Dr. John William Petersen do his residency?
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Where did Dr. John William Petersen do his fellowship?
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Is Dr. John William Petersen board certified?
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What type of doctor is Dr. John William Petersen
Neurology
In what state does Dr. John William Petersen practice in?
Minnesota
Where is Dr. John William Petersen ’s practice located?
12000 Elm Creek Blvd N Ste L70 , Maple Grove, Minnesota, 55369-7167
What is Dr. John William Petersen ’s gender?
Male
Is Dr. John William Petersen a sole practitioner?
No
Is Dr. John William Petersen accepting new patients?
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What languages does Dr. John William Petersen speak?
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Does Dr. John William Petersen accept insurance?
Yes, Dr. John William Petersen accepts insurance
Does Dr. John William Petersen offers telemedicine?
Dr. John William Petersen has not indicated if he offers telemedicine
What is Dr. John William Petersen ’s professional license number?
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What is Dr. John William Petersen ’s NPI number?
1720110737
Does Dr. John William Petersen have any license restrictions?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NN0400X | Neurology | 1764 | MN |
National Provider Identifier
| NPI | 1720110737 |
|---|---|
| Provider Name | Dr. John William Petersen |
| First Address | Maple Grove, MN 55369-7167 |
| Second Address | Maple Grove, MN 55369-7167 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/03/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
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)
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?
Subparts are the components and separate physical locations of organization health care providers.
Subpart examples include: Hospital components include outpatient departments, surgical centers,
psychiatric units, and laboratories. These components are often separately licensed or certified by
States and may exist at physical locations other than that of the hospital of which they are a
component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if
an individual) or other name by which the organization provider is or has been known. The code
identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date
The date that a NPI record was last updated or changed
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the PI application or to officially change data for a health care provider.