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Individual

PETER M STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 MARIO CAPECCHI DR, 4550, SLC, UT 84113-1103
(801) 662-5600
Mailing address
PO BOX 413026, SALT LAKE CITY, UT 84141-3026
(801) 213-3900

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
157103-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200038200
RAILROAD MEDICARE
UT
Enumeration date
05/24/2006
Last updated
01/02/2014
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