Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jeffrey E Petersen, MD

Individual provider Dermatology Physician · NPI 1275551707

Dr. Jeffrey E Petersen, MD is a Dermatology in Fenton, Missouri. Graduated from Indiana University School of Medicine in 1995, 31 years ago. Practices with St Louis Dermatology LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
31
Trained at
Indiana University School of Medicine
Licensed in
MO
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1011 Bowles Ave Ste 121
Fenton, MO 63026-2395
Phone: (314) 200-2713
Fax: (314) 200-2714
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 2001020599 (MO)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence 2001020599 (MO)

Record details

NPI number1275551707
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 17, 2006
Last updated in NPPESJuly 25, 2014
Mailing address1011 Bowles Ave, Suite 121, Fenton, MO 63026-2395

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolINDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated 1995 (31 years in practice)
Group practice St Louis Dermatology Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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