Steve Alan Petersen, MD

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

D0065131 Issued in MD

Practice address

5601 Loch Raven Blvd
Smyth BLDG, Suite G-1
Baltimore, MD 21239-2945

Phone

(443) 444-4740

Fax

(443) 444-4752

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1205874385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "SMYTH BLDG, SUITE G-1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4740",
            "fax_number": "443-444-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "SMYTH BLDG, SUITE G-1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4740",
            "fax_number": "443-444-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "STEVE",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MD",
            "license": "D0065131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012124000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Peters, MD
• Carl Evers Petersen, D.O.
• Jaime Petersen
• Julie Petersen, PHD
• Kerry Elizabeth Petersen
• Abby Mackenzie Peterson
• Claire Peterson
• Daniel Albin Peterson, M.D.
• Emma Lee Peterson, PH.D
• Evan T Peterson, PT, DPT

• Adult Reconstructive Orthopaedic Surgery Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.