Dr Jennifer M Peterson, MD | |
1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 | |
(701) 795-2000 | |
(701) 780-1896 |
Full Name | Dr Jennifer M Peterson |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, North Dakota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144333022 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 6615A (Wyoming) | Secondary |
208000000X | Pediatrics | 41901 (Minnesota) | Secondary |
208000000X | Pediatrics | 12080 (North Dakota) | Primary |
Entity Name | Altru Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760494330 PECOS PAC ID: 1355251604 Enrollment ID: O20031110000135 |
Mailing Address | Practice Location Address |
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Dr Jennifer M Peterson, MD 2401 Demers Ave, Grand Forks, ND 58201 Ph: (701) 780-1891 | Dr Jennifer M Peterson, MD 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 Ph: (701) 795-2000 |
Lori A Sondrol, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medical Center, Grand Forks, ND 58201 Phone: 701-795-2000 | |
Mr. Miltiadis Douvoyiannis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-795-2000 Fax: 701-780-4477 | |
Bernard Jerome Hoggarth, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 S Columbia Road, Grand Forks, ND 58206 Phone: 701-780-5000 Fax: 701-780-1942 | |
Susan K Zelewski, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 Phone: 701-795-2000 | |
Dr. Nicole Marie Zimmerman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-795-2000 | |
Mrs. Gloria A Adjekum, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1380 S Columbia Rd - Altru Family Medicine Center, Grand Forks, ND 58201 Phone: 701-795-2000 Fax: 212-939-4022 |