Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A125052 | CA |
Y | 207VX0201X | Gynecologic Oncologist | 51046 | MT |
NPI | 1215181029 |
---|---|
Provider Name | Dr. Megan Marie Clute Petersen |
First Address | Billings, MT 59101-0905 |
Second Address | Billings, MT 59101-0905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2008 |
Last Update Date | 18/01/2022 |