Cory Peterson, is a
Student In An Organized Health Care Education/training Program based in Minneapolis, Minnesota. Cory Peterson is licensed to practice in Minnesota (license number R668) and his current practice location is
701 25th Ave S Ste 400, Minneapolis, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(612) 659-4900.
NPI number for Cory Peterson is 1699049627 and his current mailing address is 701 25th Ave S Ste 400, Minneapolis, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1699049627.
Healthcare Provider's Profile
| Full Name | Cory Peterson |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 701 25th Ave S Ste 400, Minneapolis, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1699049627
- Provider Enumeration Date: 03/08/2012
- Last Update Date: 07/21/2022
Medical Identifiers
Medical identifiers for Cory Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699049627 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 7015 (Nebraska) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | R668 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Cory Peterson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Cory Peterson,
701 25th Ave S Ste 400,
Minneapolis, MN 55454-1443
Ph: (612) 659-4900 | Cory Peterson,
701 25th Ave S Ste 400,
Minneapolis, MN 55454-1443
Ph: (612) 659-4900 |
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