NPI 1982900825

David S. Petersen, M.D.S.C.

Organisation Urology Physician Moline, IL

Practice location

Address: 2121 1st Street a, Moline, IL 61265-7745
Phone: (309) 764-9790
Fax: (309) 764-9632

Authorised official

Name: David S Petersen
Title: President
Phone: (309) 764-9790

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 036-055984 (IL)

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Registry record

NPI: 1982900825
Entity type: Organization
NPI issued: 9 Feb 2011
Record last updated: 9 Feb 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.