NPI 1477607083

Matthew D. Petersen, ST

Practitioner Surgical Technologist Omaha, NE

Practice location

Address: 11704 W Center Rd STE 200, Omaha, NE 68144-4327
Phone: (402) 691-0500
Fax: (402) 691-1586
Mailing address: 20 Elmwood Dr, Council Bluffs, IA 51503-1623

Registered specialties

Surgical Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZS0410X

Other Specialist/Technologist, Other providers in Nebraska →

Registry record

NPI: 1477607083
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jan 2007
Record last updated: 8 Jul 2007

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.