Petersen, David B
Petersen, David B is an individual health care provider with primary practice located at 4400 So 700 E 100, Salt Lake City UT 84107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Petersen, David B can be contacted via phone (801) 264-4450.Contact Information
Primary practice address
4400 So 700 E 100
Salt Lake City UT 84107
Phone: (801) 264-4450
Fax: (801) 264-4409
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 52616771205 | Utah |
Profile Details
| NPI number | 1851482202 |
|---|---|
| LBN Legal business name | Petersen, David B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851482202 | NPPES |
| Utah | MEDICAID | 870544230002 |
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