Individual
DR. MICHAEL WARREN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
114 EAST 800 NORTH, SPANISH FORK, UT 84660
(801) 794-1490
(801) 794-1495
Mailing address
732 N MAIN ST, SPRINGVILLE, UT 84663-1034
(801) 704-7001
(801) 210-7012
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
47784-021
WI
207N00000X
Dermatology Physician
Primary
7247463-1204
UT
Other
Enumeration date
01/15/2007
Last updated
04/13/2018
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