Michael W Peterson (NPI# 1770634909, PAC ID# 5395915896) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1770634909 |
| PAC ID by PECOS | 5395915896 |
| Professional Enrollment ID | I20110818000689 |
| Full Name | Michael W Peterson |
| Address |
732 N Main St Springville UT 84663-1034 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 2007 |
| Primary Specialty | DERMATOLOGY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460001 | UTAH VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1700 Sycamore Ave, Kingman, AZ 86409-0927 | 9286928885 | ARIZONA DESERT DERMATOLOGY AND SURGERY PC |
| 2091 N Smoketree Ave, Suite 103, Lake Havasu City, AZ 86403-5896 | 9284533332 | ARIZONA DESERT DERMATOLOGY AND SURGERY PC |
| 732 N Main St, Springville, UT 84663-1034 |
| Street Address |
732 N MAIN ST |
| City | SPRINGVILLE |
| State | UT |
| Zip | 84663-1034 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jared R Young | Qualified Audiologist | 528 N Main St, Springville, UT 84663-1073 | |
| Michael S Mclay | Family Medicine | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| Matthew G Ollerton | Podiatry | Foot and Ankle Clinics of Utah, P.C. | 5 E 400, Springville, UT 84663-1347 |
| Kathryn C Morrill | Nurse Practitioner | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| Russell J Beckstead | Family Medicine | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| Emily G Dunn | Nurse Practitioner | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| John W Manwaring | Physician Assistant | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| John S Taylor | Family Medicine | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| Marc A Penrod | Family Medicine | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| Brayden Thomas Mcbride | Family Medicine | Canyon View Medical Group LLC | 5 E 400, Springville, UT 84663-1347 |
| Find all physicians in zip 84663 | |||
| City | SPRINGVILLE |
| Zip Code | 84663 |
| Specialty | DERMATOLOGY |
| City + Specialty | SPRINGVILLE + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.