person
Shane Stean Peterson, DO
Student in an Organized Health Care Education/Training Program in Hartford, Connecticut
NPI 1609439066

Shane Stean Peterson is a Student in an Organized Health Care Education/Training Program based in Peoria, CT. Shane Stean Peterson practices in Hartford, CT and has the professional credentials of DO. The NPI Number for Shane Stean Peterson is 1609439066 and holds a License No. (Connecticut).

The current practice location address for Shane Stean Peterson is 80 Seymour St, Hartford, CT and can be reached out via phone at 860-972-2864 and via fax at 860-545-5646.

Location: 80 Seymour St, Hartford, CT, 85382-4864
person
Provider Profile Details
NPI Number
1609439066
Provider Name
Shane Stean Peterson
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
80 Seymour St, Hartford, CT, 85382-4864
Phone Number
860-972-2864
Fax Number
860-545-5646
Provider Enumeration Date
04/20/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
80 Seymour St
City
State
Zip
06106-3315
Phone Number
860-972-2864
Fax Number
860-545-5646
person
Provider Business Mailing Address Details
Address
80 Seymour St
City
State
Zip
06106-3315
Phone Number
860-972-2864
Fax Number
860-545-5646
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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