Organization
SPRINGVILLE DERMATOLOGY & DIAGNOSTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WARREN PETERSON DO (OWNER/PHYSICIAN)
(801) 704-7001
Entity
Organization
Contact information
Practice address
732 N MAIN ST, SPRINGVILLE, UT 84663-1034
(801) 704-7001
(801) 210-7012
Mailing address
732 N MAIN ST, SPRINGVILLE, UT 84663-1034
(801) 704-7001
(801) 210-7012
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
72474631204
UT
Other
Enumeration date
06/19/2013
Last updated
06/18/2025
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