Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL GUSTAVO PETERSON
Active Sole ProprietorMICHAEL GUSTAVO PETERSON is a Pharmacy healthcare provider located in GOTHENBURG, Nebraska. NPI 1134790090 is currently active in the NPPES registry. Verify at CMS.
Pharmacy · GOTHENBURG, NE
Registration Details
- NPI Number
- 1134790090
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 1, 2021 (5.1134827688683 yrs)
- Last Updated
- Jul 7, 2021
- License
-
805 (NE)
- Sole Proprietor
- Yes
Practice Information
- Address
-
718 4TH STGOTHENBURG, NE, 691382347Browse NE providers · Browse ZIP 69138
- Phone
- 3085372048
- Fax
- 3085372231
- Primary Specialty
-
Pharmacy
333600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.