| Peter V Sundwall Jr, MD | |
| 
					10290 N North County Blvd, Suite 200, Highland, UT 84003-8400  | |
| (801) 899-3391 | |
| (801) 685-3266 | 
| Full Name | Peter V Sundwall Jr | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 10290 N North County Blvd, 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 | 
|---|---|---|---|
| 1558470641 | NPI | - | NPPES | 
| D1942 | Medicaid | UT | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 3393791205 (Utah) | Primary | 
| Entity Name | Alpine Family Medicine Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1427207836 PECOS PAC ID: 7911074828 Enrollment ID: O20080918000325  | 
| Entity Name | Preservemd Llc | 
|---|---|
| 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 V Sundwall Jr, MD 10290 N North County Blvd, Suite 200, Highland, UT 84003-1819 Ph: (801) 899-3391  | Peter V Sundwall Jr, MD 10290 N North County Blvd, Suite 200, Highland, UT 84003-8400 Ph: (801) 899-3391  | 
Peter Michael Sundwall,  Family Medicine Medicare: Medicare Enrolled Practice Location: 10290 N. North County Blvd. Ste 200, Highland, UT 84003 Phone: 208-625-6000 Fax: 208-625-6001  | |
Leah Marie Gonzalez, PA-C Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 10290 N North County Blvd Ste 200, Highland, UT 84003 Phone: 801-899-3391  | |
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  | |
Tyler S Carroll, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10968 N Alpine Hwy, Highland, UT 84003 Phone: 801-763-2900  | |
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  |