NPI 1346028149

Maverick Lee Peterson

Practitioner Independent Duty Medical Technicians Cannon Afb, NM

Practice location

Address: 224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103
Phone: (715) 817-6949

Registered specialties

Independent Duty Medical Technicians Primary

Other Service Providers Taxonomy 1710I1003X

Other Military Health Care Provider providers in New Mexico →

Registry record

NPI: 1346028149
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Sep 2023
Record last updated: 2 Feb 2024

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.