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General NPI Number Information
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NPI Number | 1376905497
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Entity Type | Individual
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Provider Name | PETER HALE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 50 N MEDICAL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-581-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 637 S MAIN ST
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City | BOUNTIFUL
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State | UT
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Zip | 84010-6364
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Country | US
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Telephone | 435-994-8215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 1376905497
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | M-16598
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License Number State | ID
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