Dr Thomas Michael Peterson, MD | |
4700 S Washington St Ste G, Grand Forks, ND 58201-8123 | |
(701) 205-3000 | |
(701) 732-2501 |
Full Name | Dr Thomas Michael Peterson |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 4700 S Washington St Ste G, 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 |
---|---|---|---|
1639131014 | NPI | - | NPPES |
17392 | Medicaid | ND | |
878583000 | Medicaid | MN | |
12325 | Other | ND | ND BC/BS |
1460891 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 6217 (North Dakota) | Primary |
Entity Name | Peterson Medical Clinics Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699295774 PECOS PAC ID: 9335412220 Enrollment ID: O20170828003640 |
Mailing Address | Practice Location Address |
---|---|
Dr Thomas Michael Peterson, MD Po Box 5210, Grand Forks, ND 58206-5210 Ph: (701) 205-3000 | Dr Thomas Michael Peterson, MD 4700 S Washington St Ste G, Grand Forks, ND 58201-8123 Ph: (701) 205-3000 |
Dr. Matthew Joseph Roller, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1300 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-2300 | |
Ryan Ashley Greene, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 4700 S Washington St Ste G, Grand Forks, ND 58201 Phone: 701-205-3000 Fax: 701-732-2501 | |
Dr. William Benjamin Pryatel Jr., M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1200 S. Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-5000 Fax: 701-253-3999 | |
Kathryn M. Tevington, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 151 S 4th St, Suite 401, Grand Forks, ND 58201 Phone: 701-795-3000 Fax: 701-795-3050 | |
Dr. Rose J. Julius, DO Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1200 S Columbia Rd - Altru Health System, Grand Forks, ND 58201 Phone: 701-780-5000 Fax: 701-780-3472 | |
Dr. Kenneth Chidi Asogwa, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 860 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-6697 Fax: 701-780-1507 | |
Jinal Desai, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: Altru Health System, 1200 South Columbia Road, Grand Forks, ND 58201 Phone: 701-780-5000 Fax: 701-780-4477 |