Peter Michael Sundwall, | |
10290 N. North County Blvd. Ste 200, Highland, UT 84003-8400 | |
(208) 625-6000 | |
(208) 625-6001 |
Full Name | Peter Michael Sundwall |
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Gender | Male |
Speciality | Family Medicine |
Location | 10290 N. North County Blvd. Ste 200, Highland, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003306473 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 12158239-1205 (Utah) | Primary |
Entity Name | Preservemd Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942881867 PECOS PAC ID: 0244638104 Enrollment ID: O20211006002104 |
Mailing Address | Practice Location Address |
---|---|
Peter Michael Sundwall, 10290 N North County Blvd Ste 200, Highland, UT 84003-8973 Ph: (801) 899-3391 | Peter Michael Sundwall, 10290 N. North County Blvd. Ste 200, Highland, UT 84003-8400 Ph: (208) 625-6000 |
Dr. Charles Wesley Walton, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 11286 N Tamarack Dr, Highland, UT 84003 Phone: 801-492-9162 Fax: 801-492-9163 | |
Robert W Slack, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10968 N Alpine Hwy, Highland, UT 84003 Phone: 801-763-2900 | |
Tyler S Carroll, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10968 N Alpine Hwy, Highland, UT 84003 Phone: 801-763-2900 | |
Peter V Sundwall Jr., M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 10290 N North County Blvd, Suite 200, Highland, UT 84003 Phone: 801-899-3391 Fax: 801-685-3266 | |
Jeanne Marie Borget, APRN Family Medicine Medicare: Medicare Enrolled Practice Location: 10644 N 5660 W, Highland, UT 84003 Phone: 801-664-7679 | |
Terrance Stephen Drake, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 5563 Coventry Rd, Highland, UT 84003 Phone: 801-216-4581 |