Mitchell Alan Peterson, MD
Pediatrics in South Jordan, UT. Individual provider (NPI-1).
NPI number1629489596
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1629489596
- Entity type
- Individual (NPI-1)
- Name
- Mitchell Alan Peterson
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 14, 2014
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 9529304-1205 | UT | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1268 W South Jordan Pkwy Ste 201South Jordan, UT 84095-4653
Phone 801-254-9700
Mailing address
1268 W South Jordan Pkwy Ste 201South Jordan, UT 84095-4653
Phone 801-254-9700
Other practice locations
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Salt Lake City, UT 84113-1103
Phone 801-662-5700
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