DOUGLAS PETERSON (NPI# 1720015597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720015597 |
| Entity Type | Individual |
| Full Name | DOUGLAS PETERSON |
| Credential | M.D. |
| Practice Address |
900 E Broadway Ave Bismarck ND 58501-4520 |
| Mailing Address |
Po Box 997 Bismarck ND 58502-0997 |
| Practice Telephone | 7015307000 |
| Mailing Telephone | 7015307000 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2016-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
5206 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 1452800 | 05 | |
| ND | RAILROAD MEDICARE | P00441490 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972071777 | Douglas Peterson | Acupuncturist | 333 E 46th St Apt 1j, New York, NY 10017-7426 | 2018-11-09 |
| 1952520710 | Douglas Don Peterson | Dentist | 2411 10th Ave N, Lake Worth, FL 33461-3128 | 2007-04-24 |
| 1770688756 | Douglas Bruce Peterson | Dentist | 8470 Us Hwy 2, Iron River, WI 54847-0400 | 2006-09-14 |
| 1437267440 | Douglas B Peterson | Internal Medicine | 1512 W 4th St, Marshfield, WI 54449-2509 | 2006-08-29 |
| 1710962832 | Douglas Peterson | Emergency Medicine | 1630 Anderson Ave, Buffalo, MN 55313-2945 | 2005-12-13 |
| 1982688388 | Douglas George Peterson | Chiropractor | 3030 Sw Moody Ave, Ste 102, Portland, OR 97201-4867 | 2005-11-30 |
| 1932399938 | Douglas Allen Peterson | Clinical Neuropsychologist | 16935 W Bernardo Dr, 238, San Diego, CA 92127-1634 | 2007-07-26 |
| 1609083856 | Douglas A Peterson | Dentist | 9 Middletown Lincroft Rd, Lincroft, NJ 07738-1511 | 2007-05-17 |
| 1174739288 | Douglas Charles Peterson | Pediatrics | 9260 Laguna Springs Dr, Suite E2-308, Elk Grove, CA 95758-7947 | 2007-05-15 |
| 1023142585 | Douglas Jed Peterson | Chiropractor | 650 N State St, Suite #1, Shelley, ID 83274-5167 | 2007-03-15 |
| Street Address |
900 E BROADWAY AVE |
| City | BISMARCK |
| State | ND |
| Zip Code | 58501-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720087000 | Kym L Chandler | Neurological Surgery | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2005-07-19 |
| 1538769633 | Brenton Michael Green | Physician Assistant | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-10-28 |
| 1679186852 | Carly Marie Meyer | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-08-26 |
| 1164030169 | Heather Brooke Flaa | Physician Assistant | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-07-16 |
| 1699393454 | Alexis Schulz | Nurse Practitioner | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-07-08 |
| 1457971012 | Byul You | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-04-23 |
| 1962021618 | Amanda Mcglasson | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-04-13 |
| 1336772839 | Deanne Hice | Nurse Anesthetist, Certified Registered | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-02-13 |
| 1538707898 | Jenna Etzold | Psychologist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2019-12-18 |
| 1548811169 | Sarah Skeie | Nurse Practitioner | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500911 | Sonja Lee Bosch | Counselor | 101 E. Broadway Ave Heartview Foundation, Bismarck, ND 58501 | 2020-08-28 |
| 1649740630 | Stephanie Marie Simburger | Social Worker | 3111 East Broadway Ave, Bismarck, ND 58501 | 2018-12-03 |
| 1679042519 | Prairie Rose Family Dentists | Dentist | 1110 College Dr., Suite 110, Bismark, ND 58501 | 2018-11-21 |
| 1386111276 | Arielle Joy Flynn | Genetic Counselor, MS | 414 N Seventh Street, Bismarck, ND 58501 | 2018-10-29 |
| 1164901799 | Karalee Joy Harper | Counselor | 101 E. Broadway Ave, Bismarck, ND 58501 | 2018-08-14 |
| 1518457811 | Myckenzie Saari | Behavior Technician | 1929 N Washington St., Bismarck, ND 58501 | 2018-05-14 |
| 1831687532 | Jacquelyn Mahoney | Behavioral Analyst | 604 North Ave, Bismarck, ND 58501 | 2018-04-27 |
| 1710403811 | Kayla Marie Watson | Behavior Technician | 1500 E. Capitol Ave, Suite 200, Bismarck, ND 58501 | 2017-08-21 |
| 1306368220 | Scott Vandyke | Occupational Therapist | 300 N. 7th St, Bismarck, ND 58501 | 2017-07-12 |
| 1144670019 | Bismarck Psychological Associates, Pllc | Psychologist | 107 W. Main Ave., Suite 225, Bismarck, ND 58501 | 2016-06-21 |
| Find all providers in zip 58501 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902826340 | Edward F Fogarty | Radiology | 800 Munich Dr, Bismarck, ND 58504-7050 | 2006-07-20 |
| 1962769059 | Luke B Roller | Radiology | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2012-04-13 |
| 1982983201 | Andrew J Miller | Radiology | 222 N 7th St, Bismarck, ND 58501-4436 | 2011-08-04 |
| 1801110101 | Nicholas Coren Bradbury | Radiology | 310 N 10th St, Bismarck, ND 58501-4516 | 2010-03-16 |
| 1669634184 | Ryan Hegge | Radiology | 222 N 7th St, Bismarck, ND 58501-4436 | 2008-06-26 |
| 1144480971 | Christina Marie Tello-skjerseth | Radiology | 222 N 7th St, Bismarck, ND 58501-4436 | 2008-06-16 |
| 1508032103 | Bruce Allen Gardner | Radiology | 222 N 7th St, Bismarck, ND 58501-4436 | 2008-05-02 |
| 1679746218 | Daniel David Tarver | Radiology | 310 N 10th St, Bismarck, ND 58501-4516 | 2008-04-03 |
| 1346448925 | John Arthur Miller | Radiology | 222 N 7th St, Bismarck, ND 58501-4436 | 2007-07-05 |
| 1902966856 | Paul B Jahn | Radiology | 310 N 10th Street, Bismarck, ND 58501-4516 | 2006-12-11 |
| Find all providers in BISMARCK | ||||
Please comment or provide details below to improve the information on DOUGLAS PETERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.