Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLES SMITH PETERSON, M.D.
ActiveDR. CHARLES SMITH PETERSON, M.D. is a Sports Medicine healthcare provider located in MESA, Arizona. NPI 1952302143 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · MESA, AZ
Registration Details
- NPI Number
- 1952302143
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 10, 2005 (21.042692800279 yrs)
- Last Updated
- Jul 30, 2019
- License
-
28027 (AZ)
Practice Information
- Address
-
3130 E BASELINE RDSUITE 101MESA, AZ, 852047290Browse AZ providers · Browse ZIP 85204
- Phone
- 4805583744
- Fax
- 4805583801
- Primary Specialty
-
Sports Medicine
207QS0010X
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.