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Organization

PETER V SUNDWALL MD PCA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETER V SUNDWALL MD PCA (OWNER)
(801) 262-2443
Entity
Organization

Contact information

Practice address
4815 CENTER ST, MURRAY, UT 84107-4814
(801) 262-2443
(801) 262-8869
Mailing address
4815 CENTER ST, MURRAY, UT 84107-4814
(801) 262-2443
(801) 262-8869

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1498871205
UT
207Q00000X
Family Medicine Physician
1498878905
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
528447834000
UT
Enumeration date
12/14/2007
Last updated
03/27/2008
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