| Dr David Sigurd Petersen, MD | |
|
2121 1st Street A, Moline, IL 61265-7745 | |
| (309) 764-9790 | |
| (309) 526-8995 |
| Full Name | Dr David Sigurd Petersen |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 56 Years |
| Location | 2121 1st Street A, Moline, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821145590 | NPI | - | NPPES |
| 036055984 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 036055984 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Genesis Hlth System Dba Genesis Mdl Ctr-illini | Silvis, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Urological Associates Pc | 7618866815 | 15 |
| Urological Associates Pc | 7618866815 | 15 |
| Entity Name | Urological Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346229192 PECOS PAC ID: 7618866815 Enrollment ID: O20051202000161 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Sigurd Petersen, MD 2121 1st Street A, Moline, IL 61265-7745 Ph: (309) 764-9790 | Dr David Sigurd Petersen, MD 2121 1st Street A, Moline, IL 61265-7745 Ph: (309) 764-9790 |
Dr. Roger L Lubbers, MD Urology Medicare: Medicare Enrolled Practice Location: 608 35th Ave, Moline, IL 61265 Phone: 309-277-3500 Fax: 309-277-3050 | |
Dr. Brian P Engebrecht, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 608 35th Ave, Moline, IL 61265 Phone: 309-277-3500 Fax: 309-277-3050 | |
Dr. Morris J Gist, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 608 35th Ave, Moline, IL 61265 Phone: 309-277-3500 Fax: 309-277-3050 |