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Individual

DR. PETER GEORGE FORSTALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
425 E 5350 S STE 400, OGDEN, UT 84405-6932
(801) 476-0184
(801) 479-5642
Mailing address
PO BOX 741729, ATLANTA, GA 30374-1729

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
5416513-1205
UT
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
5416513-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1477643179
GROUP NPI
Enumeration date
03/02/2009
Last updated
01/13/2022
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