DR. DAVID B PETERSEN (NPI# 1851482202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851482202 |
| Entity Type | Individual |
| Full Name | DR. DAVID B PETERSEN |
| Credential | MD |
| Practice Address |
4400 So 700 E 100 Salt Lake City UT 84107 |
| Mailing Address |
4400 South 700 E 100 Salt Lake City UT 84107 |
| Practice Telephone | 8012644450 |
| Practice Fax Number | 8012644409 |
| Mailing Telephone | 8012644450 |
| Mailing Fax Number | 8012644409 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 52616771205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 870544230002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295112951 | David Petersen | Student in an Organized Health Care Education/Training Program | 1648 N Venetian Way, Saratoga Springs, UT 84045-3150 | 2015-05-01 |
| 1821114968 | David Petersen | Physical Therapist | 164 Circle Dr, Cottontown, TN 37048-4619 | 2007-03-21 |
| 1821145590 | David Sigurd Petersen | Urology | 2121 1st Street A, Moline, IL 61265-7745 | 2007-01-04 |
| 1942250808 | David James Petersen | Podiatrist | 24191 Paseo De Valencia, Suite E, Laguna Woods, CA 92637-3167 | 2006-05-11 |
| 1669454062 | David Petersen | Registered Nurse | 460 State Rd #7, Ste 300, Royal Palm Beach, FL 33411 | 2005-11-19 |
| 1750363149 | David A Petersen | Orthopaedic Surgery | 361 Hospital Rd Ste 527, Newport Beach, CA 92663-3526 | 2005-11-19 |
| 1225497894 | David Petersen | Nurse Practitioner | 471 Hepburn St, Williamsport, PA 17701-6122 | 2016-02-11 |
| 1679764989 | David H Petersen | Social Worker | 6112 S 1550 E, Ogden, UT 84405-5007 | 2007-08-05 |
| 1164633632 | David Petersen | Counselor | University of Maryland, 1209 Shoemaker Building, College Park, MD 20742-0001 | 2007-05-25 |
| 1194848655 | David G Petersen | Dentist | 123 W Francis Ave Ste 104, Spokane, WA 99205-6348 | 2007-04-09 |
| Street Address |
4400 SO 700 E 100 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1699126680 | Judd Michael Cahoon | Ophthalmology | 3281 E Santa Rosa Ave, Salt Lake City, UT 84109-4128 | 2016-06-30 |
| 1356706469 | John Christian Nelson | Ophthalmology | 3449 South 4155 West, Salt Lake City, UT 84109-2468 | 2015-12-17 |
| 1558660308 | Brian E Zaugg | Ophthalmology | John A Moran Eye Center 65 Mario Capecchi Dr, Salt Lake City, UT 84132-0001 | 2011-03-18 |
| 1770880346 | Gary Ricks Jones | Ophthalmology | 1924 S View St, Salt Lake City, UT 84105-3712 | 2011-02-17 |
| 1861792665 | Susan Crawford Chortkoff | Ophthalmology | John A Moran Eye Ctr, 65 North Mario Capecchi Drive, Salt Lake City, UT 84132-0001 | 2010-10-26 |
| 1689991747 | Kian Eftekhari | Ophthalmology | Eyelid Center of Utah, 22 S 900 E, Salt Lake City, UT 84102 | 2010-04-29 |
| 1760621940 | Bryan Paul Hemard Sr. | Ophthalmology | 6308 Canyon Cove Dr, Salt Lake City, UT 84121-6336 | 2009-02-12 |
| 1689833436 | Surgical Care Associates | Ophthalmology | 1025 East 3300 South, Suite B, Salt Lake City, UT 84106-4389 | 2008-06-06 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.