Gary J. Peterson, MD

Vascular Surgery Physician · Saint Louis, MO

Individual Active NPI

NPI number 1902900517

Practice location

10012 Kennerly Rd
Suite 305
Saint Louis, MO 63128-2197
Phone
(314) 525-4325
Fax
(314) 525-4365

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NPI record

NPI
1902900517
Entity type
Individual (Type 1)
Enumeration date
September 12, 2006
Last updated
May 24, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Vascular Surgery Physician Primary 2086S0129X R5836 MO

About Dr. Peterson

Gary J. Peterson, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Vascular Surgery Physician (code 2086S0129X). The practice location is 10012 Kennerly Rd, Suite 305, Saint Louis, MO 63128-2197. The NPI number 1902900517 was assigned on September 12, 2006 and the record was last updated on May 24, 2016.

Dr. Peterson lists a license in the registry: #R5836 (MO) for Vascular Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gary J. Peterson, MD?

The NPI number is 1902900517.

What is the phone number of Dr. Peterson?

The phone number listed for the practice location is (314) 525-4325.

Where is Dr. Peterson located?

10012 Kennerly Rd, Suite 305, Saint Louis, MO 63128-2197.

What is the taxonomy code for Dr. Peterson?

The primary taxonomy code is 2086S0129X – Vascular Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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