GARY PETERSEN MD NPI 1295775971

NPI Information

NPI: 1295775971
Provider Name: GARY PETERSEN, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Address:
1380 E MEDICAL CENTER DR
STE # 4100
ST GEORGE, UT
ZIP 84790
Phone: (435) 251-2900
Get Directions

Gary Petersen, MD is a cardiovascular disease internal medicine in St George, UT. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Gary Petersen, MD NPI is 1295775971. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1380 E MEDICAL CENTER DR
STE # 4100
ST GEORGE, UT
ZIP 84790-156
Phone: (435) 251-2900
Fax: (435) 251-2916

The enumeration date for this NPI number is 6/8/2006 and was last updated on 9/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	154580-1205	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000061131	MEDICARE PIN	UTAH
2	100507061	MEDICAID	UTAH
3	D20410	MEDICARE UPIN
4	005574703	MEDICARE ID-TYPE UNSPECIFIED	UTAH	MEDICARE ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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