NPI 1629284732

Chad Allan Peterson, MD

Practitioner Urology Physician Coeur D Alene, ID

Practice location

Address: 980 W Ironwood Dr STE. 104, Coeur D Alene, ID 83814-2668
Phone: (208) 667-0621
Fax: (208) 664-1709

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence M-10619 (ID)

Other Urology providers in Idaho →

Registry record

NPI: 1629284732
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 May 2007
Record last updated: 31 May 2012

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.