MR. Shaun M Petersen, PA

NPI #1497911556 in North Logan, Utah

Provider Information

NPI Number: 1497911556
Entity Type: Individual
Name: MR. Shaun M Petersen, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jul 29, 2008
Last Updated: Oct 1, 2021

Practice Location

Address: 2310 N 400 E
Address 2: STE A
City: North Logan
State: Utah
ZIP Code: 84341-1788
Phone: (435) 787-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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