MEDICARE: PETER W ANDERSON MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	51848	MN
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	PT12754	ND
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	10311897-1205	UT
4	207R00000X	Internal Medicine Physician	51848	MN

General Provider Information

NPI Number	:	1982850863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER W ANDERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 HARRISON BLVD
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84403-3195
Country	:	US
Telephone Number	:	801-387-2800
Fax Number	:

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

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	04/07/2026

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Directions to “ PETER W ANDERSON MD” Practice Location

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