Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANDREW D PETERSEN, DO
ActiveFamily Medicine · PROVO, UT
Registration Details
- NPI Number
- 1124011572
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 31, 2005 (20.63878205053 yrs)
- Last Updated
- May 21, 2014
- Licenses
-
M4441 (TX)8382699-1204 (UT)
Practice Information
- Address
-
524 W 300 N STE 203PROVO, UT, 846012669Browse UT providers · Browse ZIP 84601
- Phone
- 8016075268
- Fax
- 8016075271
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in PROVO, UT
| Name | Credential | NPI |
|---|---|---|
| DR. STEVEN W BLOINK | MD | 1891787891 |
| DR. DENNIS C HESS | M.D. | 1326035080 |
| DR. RICHARD J HOLMES | M.D. | 1083601942 |
| DR. JAMES A WOODMANSEE III | M.D. | 1093703530 |
| WESLEY D WYLIE | M.D. | 1548215197 |
| STUART B PORTER | D.O. | 1689612996 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.