Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK WILLIAM PETERSON, DO
ActiveDR. MARK WILLIAM PETERSON, DO is a Sports Medicine healthcare provider located in PARK CITY, Utah. NPI 1326374562 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · PARK CITY, UT
Registration Details
- NPI Number
- 1326374562
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 22, 2009 (16.767873859735 yrs)
- Last Updated
- Feb 18, 2020
- Licenses
-
5101018542 (MI)E7679 (AR)5101018542 (MI)8743560-1204 (UT)
Practice Information
- Address
-
2200 PARK AVE. BLDG. D STE. 100PARK CITY, UT, 84060Browse UT providers · Browse ZIP 84060
- Phone
- 4356158822
- Fax
- 4356158823
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Sports Medicine
Other Sports Medicine Providers in PARK CITY, UT
| Name | Credential | NPI |
|---|---|---|
| DR. LESLIE HARDIN RASSNER | M.D. | 1427022938 |
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.