NPI 1770634909

Michael Warren Peterson, DO

Practitioner Dermatology Physician Spanish Fork, UT

Practice location

Address: 114 East 800 North, Spanish Fork, UT 84660
Phone: (801) 794-1490
Fax: (801) 794-1495
Mailing address: 732 N Main St, Springville, UT 84663-1034

Registered specialties (2)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 7247463-1204 (UT)

Other Dermatology providers in Utah →

Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 47784-021 (WI)

Registry record

NPI: 1770634909
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jan 2007
Record last updated: 13 Apr 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.