Individual provider · Type 1 NPI

Michael James Petersen, MD

Vascular Surgery Physician · East Setauket, NY

NPI number 1902899057 Active

Practice location

4 Technology Dr, Suite 120
East Setauket, NY 11733-4068

Fax (631) 246-8294

Specialties and licenses

TaxonomyCodeLicense
Specialist 174400000X175936 (NY)
Vascular Surgery Physician Primary 2086S0129X175936 (NY)

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

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About NPI 1902899057

Michael James Petersen, MD's National Provider Identifier is 1902899057, issued on Aug 24, 2005. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in East Setauket, NY. The record was last updated on Jun 6, 2016.