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Individual
MATTHEW L PETERSON
Active
Individual
MATTHEW L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4985237-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009351150
PHCS
UT
01
—
107037417102
IHC
UT
01
—
236437
ALTIUS
UT
01
—
38892
HEALTHY U
UT
01
—
7710087
CIGNA
UT
01
—
83147
PEHP
UT
01
—
878277
DESERET MUTUAL
UT
01
—
TPRA1129
MOLINA
UT
Enumeration date
09/27/2006
Last updated
07/08/2007
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