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NPI Code Detail

MEDICARE: AARON THOMAS PETERSON M.D.

MEDICARE: AARON THOMAS PETERSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician036116322IL
22085R0204XVascular & Interventional Radiology Physician12283NV
32085R0202XDiagnostic Radiology Physician12283NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00440881OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336126721
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON THOMAS PETERSON M.D.
Provider Business Mailing Address
First Line : 3600 MINNESOTA DR STE 800
Second Line :
City : EDINA
State : MN
Zip : 55435-7915
Country : US
Telephone Number : 952-595-1100
Fax Number : 612-294-4903
Provider Business Practice Location Address
First Line : 4101 WAGON TRAIL AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-4426
Country : US
Telephone Number : 702-942-4123
Fax Number : 702-942-4124
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 03/14/2025

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Directions to “ AARON THOMAS PETERSON M.D.” Practice Location

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