Peterson, Mark William

Peterson, Mark William is an individual health care provider with primary practice located at 2200 Park Ave. Bldg. D Ste. 100 , Park City UT 84060. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Peterson, Mark William can be contacted via phone (435) 615-8822.

Contact Information

Primary practice address
2200 Park Ave. Bldg. D Ste. 100 Park City UT 84060
Phone: (435) 615-8822
Fax: (435) 615-8823
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101018542 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E7679 Arkansas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 5101018542 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 8743560-1204 Utah

Profile Details

NPI number 1326374562
LBN Legal business name Peterson, Mark William
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2009
Last updated Feb 18th, 2020 - about 5 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.

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