Nathan Jeffrey Petersen, MD
Obstetrics & Gynecology in Glendale, AZ. Individual provider (NPI-1).
NPI number1245525930
StatusActive
Last updated in NPPESNov 2, 2017
Details
- NPI
- 1245525930
- Entity type
- Individual (NPI-1)
- Name
- Nathan Jeffrey Petersen
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 10, 2011
- Last updated
- Nov 2, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 51043 | AZ | Yes |
| 207V00000X | Obstetrics & Gynecology | R72843 | AZ |
Practice location
6370 W Union Hills DrGlendale, AZ 85308-7136
Phone 623-414-3500 · Fax 623-455-9214
Mailing address
6370 W Union Hills DrGlendale, AZ 85308-7136
Phone 623-414-3500 · Fax 623-455-9214
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