Individual
CHARLES MATTHEW PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N 1900 E, SUITE 2B200, SALT LAKE CITY, UT 84132-0002
(801) 587-3834
Mailing address
30 N 1900 E, SUITE 2B200, SALT LAKE CITY, UT 84132-0002
(801) 587-3834
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
172719-1205
UT
Other
Enumeration date
10/13/2006
Last updated
12/01/2021
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