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CHARLES E PETERSON MD

Individual Provider (NPI-1) Active

Provider Information

NPI Number
1326025495
Provider Type
Individual Provider (NPI-1)
Credentials
MD
Status
Active

Contact & Location

Address
621 MEMORIAL DR STE 502, SOUTH BEND, IN, 466011075
Phone
(574) 647-5875
Fax
(574) 647-5878

Specialties & Taxonomies

Unknown Primary License: IN #01028400A

All Addresses

MAILING

710 N NILES AVE

SOUTH BEND, IN, 466171924

(574) 647-1610

LOCATION

621 MEMORIAL DR STE 502

SOUTH BEND, IN, 466011075

(574) 647-5875