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Contact Information

ROBERT PETERSON, PA-C
707 ASH STREET
SPOONER, WI54801
 Phone: 715-635-2151
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ROBERT PETERSON · (Male)

NPI # 1033198957
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 01/10/2006
Last updated 09/24/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 9873
  • MN Medicaid 110533700
  • Other 410849339 56001 G011 CHAMPUS
  • MN Other 209L9PE BCBS
  • MN Other HP20659 HEALTH PARTNERS
  • MN Other 0117135 MEDICA
  • MN Other NA2951011331 PREFERRED ONE
  • MN Other 115317 UCARE
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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