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Mark Peterson, PA-C
NPI 1740397140 · on the registry since 2006
Practice
- Address
- 7540 22nd Ave
Kenosha, WI 53143 - Phone
- (262) 656-7800
- Fax
- (262) 656-7810
- Organisation at this address
- Aurora Pharmacy Inc
Aurora Medical Group, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 12
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-04-18
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 Wisconsin