Preservemd Llc | |
10290 N. County Blvd Suite 200 Highland UT 84003 | |
(801) 899-5410 | |
Not Available |
Full Name | Preservemd Llc |
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Speciality | Family Medicine |
Location | 10290 N. County Blvd, Highland, Utah |
Authorized Official Name and Position | Peter Val Sundwall (MD / OWNER) |
Authorized Official Contact | 8018995410 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Preservemd Llc 835 S East Mountain Cir Alpine UT 84004-1768 Ph: (801) 899-5410 | Preservemd Llc 10290 N. County Blvd Suite 200 Highland UT 84003 Ph: (801) 899-5410 |
NPI Number | 1942881867 |
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Provider Enumeration Date | 04/21/2021 |
Last Update Date | 04/21/2021 |
Medicare PECOS PAC ID | 0244638104 |
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Medicare Enrollment ID | O20211006002104 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942881867 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Peter V Sundwall |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558470641 PECOS PAC ID: 3678486008 Enrollment ID: I20060117001068 |
Provider Name | Peter Michael Sundwall |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003306473 PECOS PAC ID: 1153729017 Enrollment ID: I20211006002178 |
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