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General NPI Number Information
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NPI Number | 1801242383
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Entity Type | Individual
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Provider Name | KATHLEEN FRANKLIN PETERSON MD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 345 SAINT PAUL ST
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City | BALTIMORE
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State | MD
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Zip | 21202-2123
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Country | US
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Telephone | 410-332-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1822 BROADWAY RD
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City | LUTHERVILLE
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State | MD
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Zip | 21093-1401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | P32564
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License Number State | MD
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