DR. Ethan James Dean Peterson, MD is a student in an organized health care education training program in Brandon, FL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Ethan James Dean Peterson, MD NPI is 1891371480. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
119 OAKFIELD DR
BRANDON, FL
ZIP 33511-779
Phone: (813) 681-5551
Fax: (813) 916-2944
The NPI 1891371480 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 3/23/2021 and was last updated on 3/23/2021.