DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TODD CHARLES PETERSON, D.O.

Active Sole Proprietor

TODD CHARLES PETERSON, D.O. is a Sports Medicine (Orthopaedic) healthcare provider located in CLIVE, Iowa. NPI 1407085103 is currently active in the NPPES registry. Verify at CMS.

Sports Medicine (Orthopaedic) · CLIVE, IA

Registration Details

NPI Number
1407085103
Provider Type
Individual
Gender
Male
NPI Issued
Jul 2, 2009 (17.163918695125 yrs)
Last Updated
Aug 7, 2015
Licenses
5101018316 (MI)
DO-04737 (IA)
Sole Proprietor
Yes

Practice Information

Address
12499 UNIVERSITY AVE
CLIVE, IA, 503258288
Browse IA providers · Browse ZIP 50325
Phone
5154402676
Primary Specialty
Sports Medicine (Orthopaedic)
207XS0114X
Additional Specialty
Sports Medicine (Orthopaedic)
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.