Provider Demographics
NPI:1770522351
Name:PETERSON, MARGARET E (DC)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:E
Last Name:PETERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ENDERLIN
Mailing Address - State:ND
Mailing Address - Zip Code:58027-1201
Mailing Address - Country:US
Mailing Address - Phone:701-437-3888
Mailing Address - Fax:701-437-3889
Practice Address - Street 1:207 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ENDERLIN
Practice Address - State:ND
Practice Address - Zip Code:58027-1201
Practice Address - Country:US
Practice Address - Phone:701-437-3888
Practice Address - Fax:701-437-3889
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12178Medicaid
NDN713354Medicare PIN