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Contact Information

JONATHAN PETERSON, MD
1200 GRANT BLVD W
WABASHA, MN55981-1042
 Phone: 651-565-5908
 Fax: 651-565-5910
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JONATHAN PETERSON · (Male)

NPI Number 1003882010
Status Active
Credentials MD
Entity Individual
Enumeration date 02/28/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 33320
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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