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Mrs. Antonique Peterson, DO
General Practice Physician in Minneapolis, Minnesota
NPI 1700377124

Antonique Peterson is a General Practice Physician based in Minneapolis, MN. Antonique Peterson practices in Minneapolis, MN and has the professional credentials of DO. The NPI Number for Antonique Peterson is 1700377124 and holds a License No. (Minnesota).

The current practice location address for Antonique Peterson is 1313 Penn Ave N, Minneapolis, MN and can be reached out via phone at 612-543-2500.

Location: 1313 Penn Ave N, Minneapolis, MN, 55411-3047
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700377124
Provider Name
Antonique Peterson
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
1313 Penn Ave N, Minneapolis, MN, 55411-3047
Phone Number
612-543-2500
Fax Number
Provider Enumeration Date
05/21/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
416005801 05 MN
institution
Provider Business Practice Location Address Details
Address
1313 Penn Ave N
City
Minneapolis
State
Minnesota
Zip
55411-3047
Phone Number
612-543-2500
Fax Number
person
Provider Business Mailing Address Details
Address
1313 Penn Ave N
City
Minneapolis
State
Minnesota
Zip
55411-3047
Phone Number
612-543-2500
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
69440 (Minnesota)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
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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