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Contact Information

SCOTT PETERSON, DO
3777 COON RAPIDS BLVD NW STE 100
COON RAPIDS, MN55433-2630
 Phone: 763-421-7420
 Fax: 763-421-0730
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for SCOTT PETERSON · (Male)

NPI # 1598121808
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 01/04/2016
Last updated 03/17/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5101019986
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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