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

Kenneth D Petersen, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1922092733

Kenneth D Petersen, MD is an Obstetrics & Gynecology Physician in Goshen, Indiana. Licensed in Indiana. Registered with an NPI since 2005.

Licensed in
IN
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1111 Lighthouse Ln
Goshen, IN 46526-3824
Phone: (574) 533-0348
Fax: (574) 533-0277
Show map & directions

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

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 01028273 (IN)

Record details

NPI number1922092733
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 7, 2005
Last updated in NPPESFebruary 4, 2008

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