Individual
DR. DAVID B PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4400 SO 700 E, 100, SALT LAKE CITY, UT 84107
(801) 264-4450
(801) 264-4409
Mailing address
4400 SOUTH 700 E, 100, SALT LAKE CITY, UT 84107
(801) 264-4450
(801) 264-4409
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
52616771205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870544230002
—
UT
Enumeration date
09/28/2006
Last updated
10/07/2024
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