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

Mr. Todd J Petersen, PA-C

Individual provider Physician Assistant · NPI 1740270537

Mr. Todd J Petersen, PA-C is a Physician Assistant in Florissant, Missouri. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6854 Parker Rd
Florissant, MO 63033-5313
Phone: (314) 286-6988
Fax: (314) 868-2561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-002723 (IL)

Record details

NPI number1740270537
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 24, 2005
Last updated in NPPESApril 15, 2024
Certification dateApril 15, 2024

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