1841381332 NPI number — RICHARD M PETERSEN L.M.F.T. M.A.C.

Table of content: RICHARD M PETERSEN L.M.F.T. M.A.C. (NPI 1841381332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841381332 NPI number — RICHARD M PETERSEN L.M.F.T. M.A.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PETERSEN
Provider First Name:
RICHARD
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.M.F.T. M.A.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841381332
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
USAMEDDAC WUERZBURG, UNIT 26610
Provider Second Line Business Mailing Address:
ATTN: CREDENTIALS OFFICE
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09244
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
01149931843616
Provider Business Mailing Address Fax Number:
011499318043241

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USAMEDDAC WUERZBURG, ANSBACH MIDDLE HIGH SCHOOL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANSBACH
Provider Business Practice Location Address State Name:
GERMANY
Provider Business Practice Location Address Postal Code:
09177
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
09802832153
Provider Business Practice Location Address Fax Number:
098021496
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  B23678 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: #36434 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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