MARK STEVEN PETERSON (NPI# 1003980053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003980053 |
| Entity Type | Individual |
| Full Name | MARK STEVEN PETERSON |
| Credential | MD |
| Practice Address |
925 Commercial St Se Ste 102 Salem OR 97302-4173 |
| Practice Telephone | 5035617227 |
| Practice Fax Number | 5036718334 |
| Mailing Telephone | 5035617227 |
| Mailing Fax Number | 5033718334 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD16135 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 010509 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164069696 | Mark Alan Peterson | In Home Supportive Care | 5870 Nw 54th Ct, Johnston, IA 50131-1418 | 2019-12-03 |
| 1841474012 | Mark Frederic Peterson I | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3351 36th St, Grand Rapids, MI 49331 | 2007-12-24 |
| 1780877258 | Mark A. Peterson | Counselor | 7322 Scenic Oaks Cir, Austin, TX 78745-5217 | 2007-08-19 |
| 1871702076 | Mark Clayton Peterson | Dentist | 1600 W Sunset Rd Ste B, Henderson, NV 89014-2655 | 2007-05-22 |
| 1558481366 | Mark Theodore Peterson | Specialist | 5712 Newburg Rd, Rockford, IL 61108-6707 | 2007-03-29 |
| 1073608170 | Mark A Peterson | Dentist | 7740 Bay St, Suite # 1, Sebastian, FL 32958-3427 | 2006-10-04 |
| 1689782864 | Mark L Peterson | Dentist | 127 1/2 E Short St, Rigby, ID 83442-1422 | 2006-08-28 |
| 1528013661 | Mark Edward Peterson | Dentist | 2440 Gaynor Nw, Grand Rapids, MI 49544-1830 | 2006-05-24 |
| 1699763607 | Mark Delano Peterson | Orthopaedic Surgery | 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 | 2005-10-12 |
| 1477551836 | Mark Dean Peterson | Chiropractor | 5406 Alderson St, Schofield, WI 54476-2264 | 2005-07-11 |
| Street Address |
925 COMMERCIAL ST SE STE 102 |
| City | SALEM |
| State | OR |
| Zip Code | 97302-4173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144261538 | Hyong W Shim | Internal Medicine | 925 Commercial St Se Ste 102, Salem, OR 97302-4172 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225351901 | Willamette Vascular Specialists, PC | Surgery | 1015 25th St Se, Salem, OR 97301 | 2010-03-09 |
| 1174756605 | Benjamin R. Wilson, Md, PC | Surgery | 700 Bellevue Street, Suite 240, Salem, OR 97301-3855 | 2009-09-01 |
| 1508074147 | Salem Vascular Consultants, LLP | Surgery | 1535 Liberty St Se, Salem, OR 97302-4345 | 2007-05-18 |
| 1356726418 | Advanced Vascular Therapy LLC | Surgery | 2480 Liberty St Ne, Suite 110, Salem, OR 97301-8380 | 2015-07-29 |
| 1215215371 | Atish Chopra | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-07-23 |
| 1003106071 | Jeffrey David Crawford | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-04-12 |
| 1831411560 | Salem Vascular, PC | Surgery | 1535 Liberty St Se, Salem, OR 97302-4345 | 2010-02-22 |
| 1326207739 | Amani D Politano | Surgery | 875 Oak St Se Ste 5020, Salem, OR 97301-3997 | 2008-06-02 |
| 1104990175 | Rick Dewitt Pittman | Surgery | 1793 13th St Se, Salem, OR 97302-2541 | 2006-11-20 |
| 1578596938 | William Siao-ping Tung | Surgery | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2006-07-09 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on MARK STEVEN PETERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.