IndividualActive
Gary Peterson, MD
NPI 1902900517 · Vascular Surgery Physician · Saint Louis, MO
Provider details
- NPI number
- 1902900517
- Entity type
- Individual
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- R5836 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10012 Kennerly Rd
Suite 305
Saint Louis, MO 63128-2197
Phone: (314) 525-4325
Fax: (314) 525-4365
Approximate (ZIP-level) locationGet directions
Mailing address
10012 Kennerly Rd
Saint Louis, MO 63128-2197
Registry dates
- Enumerated
- 2006-09-12
- Last updated
- 2016-05-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.