Search › West Virginia › 207YX0905X
Andrew Petersen, DO
NPI 1316212517 · on the registry since 2012 · sole proprietor
Practice
- Address
- 211 W Maple Ave
Fayetteville, WV 25840 - Phone
- (304) 900-5511
- Organisation at this address
- Charleston Medical Center, Inc.
Vitality Aesthetics And Wellness, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
Additional practice sites
- 5100 W Broad St, Columbus, OH
Registry record
- Primary taxonomy
- 207YX0905X
207YX0905X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-09-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in West Virginia