MEDICARE: DR. PETER KENNETH MOSKOWITZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	3471031205	UT

General Provider Information

NPI Number	:	1144229931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER KENNETH MOSKOWITZ M.D.

Provider Business Mailing Address
First Line	:	7929 S FOREST OAKS CT
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-5737
Country	:	US
Telephone Number	:	801-274-0317
Fax Number	:	801-210-5350

Provider Business Practice Location Address
First Line	:	6360 S 3000 E
Second Line	:	STE 230
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-6923
Country	:	US
Telephone Number	:	801-523-3030
Fax Number	:	801-523-3033

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	11/26/2015

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