| Preservemd Llc | |
|
10290 N. County Blvd Suite 200 Highland UT 84003 | |
| (801) 899-5410 | |
| Not Available |
| Full Name | Preservemd Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 04/21/2021 |
| Medicare PECOS PAC ID | 0244638104 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558470641 PECOS PAC ID: 3678486008 Enrollment ID: I20060117001068 |
| Provider Name | Peter Michael Sundwall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003306473 PECOS PAC ID: 1153729017 Enrollment ID: I20211006002178 |
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