DR. DAVID SIGURD PETERSEN (NPI# 1821145590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821145590 |
| Entity Type | Individual |
| Full Name | DR. DAVID SIGURD PETERSEN |
| Credential | M.D. |
| Practice Address |
2121 1st Street A Moline IL 61265-7745 |
| Practice Telephone | 3097649790 |
| Practice Fax Number | 3095268995 |
| Mailing Telephone | 3097649790 |
| Mailing Fax Number | 3095268995 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2010-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036055984 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036055984 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295112951 | David Petersen | Student in an Organized Health Care Education/Training Program | 1648 N Venetian Way, Saratoga Springs, UT 84045-3150 | 2015-05-01 |
| 1821114968 | David Petersen | Physical Therapist | 164 Circle Dr, Cottontown, TN 37048-4619 | 2007-03-21 |
| 1851482202 | David B Petersen | Ophthalmology | 4400 So 700 E, 100, Salt Lake City, UT 84107 | 2006-09-28 |
| 1942250808 | David James Petersen | Podiatrist | 24191 Paseo De Valencia, Suite E, Laguna Woods, CA 92637-3167 | 2006-05-11 |
| 1669454062 | David Petersen | Registered Nurse | 460 State Rd #7, Ste 300, Royal Palm Beach, FL 33411 | 2005-11-19 |
| 1750363149 | David A Petersen | Orthopaedic Surgery | 361 Hospital Rd Ste 527, Newport Beach, CA 92663-3526 | 2005-11-19 |
| 1225497894 | David Petersen | Nurse Practitioner | 471 Hepburn St, Williamsport, PA 17701-6122 | 2016-02-11 |
| 1679764989 | David H Petersen | Social Worker | 6112 S 1550 E, Ogden, UT 84405-5007 | 2007-08-05 |
| 1164633632 | David Petersen | Counselor | University of Maryland, 1209 Shoemaker Building, College Park, MD 20742-0001 | 2007-05-25 |
| 1194848655 | David G Petersen | Dentist | 123 W Francis Ave Ste 104, Spokane, WA 99205-6348 | 2007-04-09 |
| Street Address |
2121 1ST STREET A |
| City | MOLINE |
| State | IL |
| Zip Code | 61265-7745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982900825 | David S. Petersen, M.d.s.c. | Urology | 2121 1st Street A, Moline, IL 61265-7745 | 2011-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427216282 | Urological Associates, P.C. | Urology | 600 Valley View Dr, Moline, IL 61265-6118 | 2008-05-29 |
| 1285606111 | Roger L Lubbers | Urology | 608 35th Ave, Moline, IL 61265-6145 | 2006-02-04 |
| 1982900825 | David S. Petersen, M.d.s.c. | Urology | 2121 1st Street A, Moline, IL 61265-7745 | 2011-02-09 |
| 1023222338 | Urological Group Ltd | Urology | 608 35th Ave, Moline, IL 61265-6145 | 2007-05-09 |
| 1902879851 | Morris J Gist | Urology | 608 35th Ave, Moline, IL 61265-6145 | 2006-02-10 |
| 1629040191 | Brian P Engebrecht | Urology | 608 35th Ave, Moline, IL 61265-6145 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| Find all providers with the same taxonomy | ||||
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| 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.