DAVID A PETERSEN MD
NPI 1619050424
Family Medicine in Lewiston, ID

Q: What is David Petersen's NPI number?

The NPI number for David Petersen is 1619050424. It was assigned to this individual provider in the NPPES registry on October 23, 2006.

Q: What is David Petersen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for David Petersen was last updated on January 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 23, 2006

2315 8TH ST, LEWISTON, ID 83501(208) 746-1383(208) 746-6348 Get Directions Write a Review

NPPES record last updated: January 18, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About David A Petersen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID A PETERSEN MD (NPI 1619050424) is an individual family medicine provider in Lewiston, Idaho, licensed in Idaho (M4779) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1619050424

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDAVID A PETERSENCredential: MD

Location Address2315 8TH STLewiston, ID 83501-7301

Mailing Address2315 8th StLewiston, ID 83501-7301 · (208) 746-1383 · Fax (208) 746-6348

Phone(208) 746-1383

Fax(208) 746-6348

Sole ProprietorNo

Enumeration DateOctober 23, 2006

Last NPPES UpdateJanuary 18, 2016

✔ NPI 1619050424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in ID · M4779✔ Licensed in WA · MD00026059

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2315 8TH ST, Lewiston, ID 83501

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Other Identifiers 10

OtherDF573ID · Blue Cross

Other31256WA · Wa Labor & Industries

Medicaid2009450WA

Other1116491ID · Dmerc

Medicaid1619050424ID

Medicare PINAB11409WA

Medicare PIN1116491ID

Other1619050424ID · Regence Blue Shield

Other80094286ID · Rr Medicare

Medicare UPINC47877ID

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALE CARASALI MD

Pediatrics