Peterson, Lee M
Peterson, Lee M is an individual health care provider with primary practice located at 3550 N University Ave Suite 250, Provo UT 84604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Peterson, Lee M can be contacted via phone (801) 374-9625.Contact Information
Primary practice address
3550 N University Ave Suite 250
Provo UT 84604
Phone: (801) 374-9625
Fax: (801) 374-9690
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 1766331205 | Utah |
Profile Details
| NPI number | 1316987613 |
|---|---|
| LBN Legal business name | Peterson, Lee M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Jul 10th, 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 | 1316987613 | NPPES |
| Utah | MEDICAID | 870516264009 |
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