Individual
DR. PETER CORLESS ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3584 W 9000 S, STE. 311, WEST JORDAN, UT 84088-5710
(801) 566-8304
Mailing address
3584 W 9000 S, STE. 311, WEST JORDAN, UT 84088-5710
(801) 566-8304
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
5366856-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5366856-1205
STATE MEDICAL LICENSE
UT
Enumeration date
05/12/2009
Last updated
06/23/2015
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