| Jerry R Petersen, MD | |
|
4695 Shoreline Dr, Spring Park, MN 55384-9715 | |
| (952) 442-7890 | |
| (952) 442-7893 |
| Full Name | Jerry R Petersen |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 4695 Shoreline Dr, Spring Park, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467451344 | NPI | - | NPPES |
| 20372 | Other | MN | MEDICAL LICENSE |
| 5093724700 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20372 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry R Petersen, MD 4695 Shoreline Dr, Spring Park, MN 55384-9715 Ph: (952) 442-7890 | Jerry R Petersen, MD 4695 Shoreline Dr, Spring Park, MN 55384-9715 Ph: (952) 442-7890 |
Dr. Julie A Dejong, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7890 | |
Steven Jay Nerheim, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7890 Fax: 952-442-7893 | |
Sheila N Seats, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7890 Fax: 952-442-7893 | |
Mary Moe Trites, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7890 Fax: 952-442-7893 |