Individual
DR. CHAD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
114 E 800 N, SPANISH FORK, UT 84660-1209
(801) 794-1490
(801) 794-1495
Mailing address
114 E 800 N, SPANISH FORK, UT 84660-1209
(801) 794-1490
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
4153
AZ
207N00000X
Dermatology Physician
5457858-1204
UT
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
54578581204
UT
Other
Enumeration date
05/29/2007
Last updated
12/06/2021
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