Provider Demographics
NPI:1972575140
Name:PETERSEN, AARON M (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:M
Last Name:PETERSEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:63 S ROCKFORD DR STE 220
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-6226
Mailing Address - Country:US
Mailing Address - Phone:480-892-8400
Mailing Address - Fax:602-508-4830
Practice Address - Street 1:560 N CAMINO MERCADO STE 1
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5759
Practice Address - Country:US
Practice Address - Phone:520-426-9224
Practice Address - Fax:602-508-4830
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-06-15
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Provider Licenses
StateLicense IDTaxonomies
AZ32807207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ883323Medicaid
AZZ82594Medicare PIN
AZI12028Medicare UPIN
AZZ82590Medicare PIN