Organization
ROBERT G PETERSON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT G PETERSON MD (PRESIDENT OF CORPORATION)
(801) 408-2233
Entity
Organization
Contact information
Practice address
370 NINTH AVE, STE 111, SALT LAKE CITY, UT 84103-2877
(801) 408-2233
(801) 408-2870
Mailing address
370 NINTH AVE, STE 111, SALT LAKE CITY, UT 84103-2877
(801) 408-2233
(801) 408-2870
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
180034-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528801589001
—
UT
Enumeration date
03/19/2008
Last updated
03/19/2008
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