Active NPI 1770634909 Individual Practitioner Male Practitioner

Dr. Michael Warren Peterson , DO

Dermatology • Spanish Fork, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Peterson, DO is a certified Dermatology practicing in Spanish Fork, UT. With approximately 26 years of clinical experience since completing medical education in 2000, Dr. Peterson delivers high-quality medical care to the local community at 114 EAST 800 NORTH.

Dr. Peterson maintains professional affiliations with Springville Dermatology And Diagnostics Pc, Arizona Desert Dermatology And Surgery Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include pathology examination of tissue using a microscope, intermediate complexity, destruction of precancer skin growth, 2-14 growths, special stained specimen slides to examine tissue, initial procedure. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

114 East 800 North

Spanish Fork, UT 84660

Telephone 8017941490

Fax 8017941495

Associated Practice Facility / Clinic

🏢 Aspen Dermatology Pllc Facility NPI 1407917107

Medicare Profile & Education

Medical School

Other

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Spanish Fork, UT

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs +2.0 yrs vs City Avg

City Avg: 24.0 Yrs

State Avg: 19.7 Yrs

Regional Practice Density

3 Specialists

Practicing in Spanish Fork, UT (184 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

56.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Peterson (26 Years) 26 Yrs

Spanish Fork Specialty Average (24.0 Years) 24.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	5,372	2,943	$75.60	$40.37
17003 Destruction of precancer skin growth, 2-14 growths	2,047	292	$70.00	$6.39
88342 Special stained specimen slides to examine tissue, initial procedure	1,374	1,111	$149.94	$95.22
88341 Special stained specimen slides to examine tissue	626	418	$134.51	$81.50
99213 Established patient office or other outpatient visit, typically 15 minutes	505	352	$170.00	$89.47
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	448	21	$811.79	$260.97
G6001 Ultrasonic guidance for placement of radiation therapy fields	439	21	$539.46	$174.65
77401 Radiation treatment delivery, superficial	434	21	$126.56	$40.14
17000 Destruction of skin growth	415	312	$149.99	$48.63
11102 Tangential biopsy of single skin lesion	245	218	$160.38	$90.85
11103 Biopsy of related skin growth, each additional growth	106	73	$180.00	$49.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	90	90	$207.98	$109.12
17110 Destruction of up to 14 skin growths	85	77	$250.00	$106.23
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	78	65	$902.79	$600.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	70	61	$85.00	$55.83
17004 Destruction of precancer skin growth, 15 or more growths	52	48	$258.46	$162.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	28	$248.62	$127.32
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	30	29	$781.56	$237.77
77300 Calculation of radiation therapy dose	25	20	$183.58	$64.83
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$122.76	$70.83
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	20	19	$1200.00	$405.10
88304 Pathology examination of tissue using a microscope, moderately low complexity	15	13	$78.01	$29.08
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	15	15	$502.78	$237.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	6,400	27	$4.45	$1.59
88305 Pathology examination of tissue using a microscope, intermediate complexity	5,024	2,840	$63.19	$42.62
17003 Destruction of precancer skin growth, 2-14 growths	3,003	372	$27.46	$6.30
88342 Special stained specimen slides to examine tissue, initial procedure	1,136	944	$130.45	$96.14
99213 Established patient office or other outpatient visit, typically 15 minutes	728	452	$143.97	$87.07
17000 Destruction of skin growth	563	411	$114.33	$45.90
88341 Special stained specimen slides to examine tissue	471	311	$113.80	$82.86
11102 Tangential biopsy of single skin lesion	351	295	$145.21	$87.38
G6001 Ultrasonic guidance for placement of radiation therapy fields	284	12	$388.64	$170.93
77401 Radiation treatment delivery, superficial	265	12	$91.18	$38.67
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	260	12	$563.11	$255.48
17110 Destruction of up to 14 skin growths	226	178	$190.10	$106.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	215	215	$176.15	$108.03
11103 Biopsy of related skin growth, each additional growth	209	123	$107.50	$48.13
88312 Special stained specimen slides to identify organisms including interpretation and report	112	47	$218.45	$106.67
17004 Destruction of precancer skin growth, 15 or more growths	111	90	$249.78	$161.07
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	92	74	$941.23	$570.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	69	64	$85.15	$54.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	42	$200.88	$122.83
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	46	15	$8.65	$1.08
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	39	35	$458.16	$259.09
88304 Pathology examination of tissue using a microscope, moderately low complexity	29	24	$69.72	$38.41
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	28	24	$721.58	$236.11
96574 Application of light with debridement to destroy precancer skin growth	27	23	$620.82	$258.72
69100 Biopsy of ear	25	23	$136.43	$67.00
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	23	20	$814.85	$395.71
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	18	18	$373.17	$111.46
77300 Calculation of radiation therapy dose	18	12	$129.59	$63.41
11900 Injection into skin growth, 1-7 growths	17	12	$82.26	$42.03
11104 Punch biopsy, first skin growth	15	14	$172.46	$112.48
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$109.33	$68.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$271.13	$161.38
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	12	12	$645.27	$256.95
77261 Simple radiation therapy planning	12	11	$136.49	$69.15
10060 Simple or single drainage of skin abscess	12	11	$216.41	$119.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	5,357	3,002	$54.49	$42.02
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	3,000	13	$2.42	$1.59
17003 Destruction of precancer skin growth, 2-14 growths	1,828	273	$9.71	$6.49
88342 Special stained specimen slides to examine tissue, initial procedure	1,008	785	$120.31	$96.64
99213 Established patient office or other outpatient visit, typically 15 minutes	552	347	$131.69	$87.69
88341 Special stained specimen slides to examine tissue	434	280	$105.27	$83.92
17000 Destruction of skin growth	402	306	$97.03	$49.65
11102 Tangential biopsy of single skin lesion	242	204	$147.84	$88.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	142	142	$162.18	$108.72
17110 Destruction of up to 14 skin growths	110	99	$162.96	$104.99
11103 Biopsy of related skin growth, each additional growth	103	68	$73.86	$49.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	91	78	$81.69	$54.19
17004 Destruction of precancer skin growth, 15 or more growths	83	71	$243.54	$163.13
88312 Special stained specimen slides to identify organisms including interpretation and report	70	33	$144.68	$108.55
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	64	51	$967.20	$588.00
88304 Pathology examination of tissue using a microscope, moderately low complexity	48	42	$59.00	$39.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	37	$186.23	$124.69
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	38	34	$439.68	$262.91
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	35	12	$1.69	$1.11
99202 New patient office or other outpatient visit, typically 20 minutes	28	28	$105.44	$70.57
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	27	25	$354.33	$136.17
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	22	16	$584.23	$394.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$243.20	$162.69
11104 Punch biopsy, first skin growth	21	21	$183.74	$120.05
69100 Biopsy of ear	17	16	$138.76	$66.23
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	12	$403.85	$157.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	6,040	3,276	$54.76	$42.56
17003 Destruction of precancer skin growth, 2-14 growths	2,111	318	$9.34	$6.22
88342 Special stained specimen slides to examine tissue, initial procedure	1,096	847	$125.03	$101.25
99213 Established patient office or other outpatient visit, typically 15 minutes	551	349	$132.36	$88.22
17000 Destruction of skin growth	488	355	$95.14	$47.30
88341 Special stained specimen slides to examine tissue	438	282	$110.86	$89.57
88312 Special stained specimen slides to identify organisms including interpretation and report	366	155	$135.91	$107.44
11102 Tangential biopsy of single skin lesion	344	297	$149.26	$90.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	181	181	$162.63	$107.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	161	128	$81.08	$54.31
11103 Biopsy of related skin growth, each additional growth	155	104	$75.92	$49.79
17110 Destruction of up to 14 skin growths	144	120	$162.92	$106.04
17004 Destruction of precancer skin growth, 15 or more growths	116	93	$238.25	$158.37
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	80	25	$1.92	$1.28
99202 New patient office or other outpatient visit, typically 20 minutes	76	76	$105.32	$69.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	48	$188.10	$126.06
88304 Pathology examination of tissue using a microscope, moderately low complexity	52	40	$59.01	$38.81
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	52	41	$974.00	$584.10
11104 Punch biopsy, first skin growth	33	29	$186.70	$119.42
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	30	28	$444.80	$238.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$243.83	$163.49
69100 Biopsy of ear	22	20	$142.80	$67.48
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$357.74	$149.96
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$450.00	$235.76
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	15	12	$22.56	$13.66
96574 Application of light with debridement to destroy precancer skin growth	15	14	$412.90	$276.19
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	12	$369.33	$150.39
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	13	12	$694.44	$286.61
11900 Injection into skin growth, 1-7 growths	13	13	$81.26	$44.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	5,363	3,063	$68.69	$42.49
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	2,200	11	$2.22	$1.47
17003 Destruction of precancer skin growth, 2-14 growths	1,760	253	$8.65	$5.50
88342 Special stained specimen slides to examine tissue, initial procedure	658	562	$119.17	$95.32
99213 Established patient office or other outpatient visit, typically 15 minutes	599	357	$109.62	$70.16
17000 Destruction of skin growth	406	297	$95.06	$46.55
88312 Special stained specimen slides to identify organisms including interpretation and report	326	143	$122.37	$95.60
11102 Tangential biopsy of single skin lesion	253	221	$144.86	$86.94
88341 Special stained specimen slides to examine tissue	241	154	$106.03	$81.91
99202 New patient office or other outpatient visit, typically 20 minutes	194	194	$110.99	$71.69
11103 Biopsy of related skin growth, each additional growth	135	85	$77.15	$48.38
17110 Destruction of up to 14 skin growths	103	88	$161.49	$102.02
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	93	75	$66.06	$42.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	81	81	$157.52	$98.05
17004 Destruction of precancer skin growth, 15 or more growths	63	57	$229.73	$147.57
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	58	17	$2.20	$1.44
11104 Punch biopsy, first skin growth	30	29	$182.06	$112.64
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	21	19	$968.07	$485.18
69100 Biopsy of ear	17	13	$142.99	$64.56
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	15	14	$439.90	$235.26
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	14	12	$23.37	$13.16
96574 Application of light with debridement to destroy precancer skin growth	11	11	$382.89	$245.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	5,792	3,520	$96.59	$46.41
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	3,000	13	$2.16	$1.42
17003 Destruction of precancer skin growth, 2-14 growths	2,043	310	$8.31	$5.42
88312 Special stained specimen slides to identify organisms including interpretation and report	723	259	$129.59	$93.48
88342 Special stained specimen slides to examine tissue, initial procedure	683	592	$103.03	$88.91
99213 Established patient office or other outpatient visit, typically 15 minutes	613	332	$109.47	$71.99
17000 Destruction of skin growth	513	361	$96.15	$48.69
11102 Tangential biopsy of single skin lesion	287	250	$144.08	$87.75
88341 Special stained specimen slides to examine tissue	258	176	$84.17	$70.21
99202 New patient office or other outpatient visit, typically 20 minutes	191	191	$112.44	$73.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	133	98	$64.86	$42.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	122	122	$160.25	$104.34
17110 Destruction of up to 14 skin growths	117	95	$160.77	$103.01
J1100 Injection, dexamethasone sodium phosphate, 1 mg	108	14	$0.18	$0.12
11103 Biopsy of related skin growth, each additional growth	96	73	$77.82	$50.56
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	89	19	$2.57	$1.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	43	$160.55	$105.69
17004 Destruction of precancer skin growth, 15 or more growths	40	40	$223.83	$147.22
11104 Punch biopsy, first skin growth	30	27	$181.08	$118.98
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	29	13	$28.72	$16.01
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	25	25	$448.31	$264.85
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	17	16	$906.24	$514.79
69100 Biopsy of ear	15	14	$144.42	$85.38
11900 Injection into skin growth, 1-7 growths	14	12	$80.13	$41.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	8,593	5,081	$111.02	$49.17
88312 Special stained specimen slides to identify organisms including interpretation and report	4,206	1,008	$135.91	$90.14
17003 Destruction of precancer skin growth, 2-14 growths	1,240	201	$12.54	$5.38
88342 Special stained specimen slides to examine tissue, initial procedure	446	395	$110.49	$93.92
99213 Established patient office or other outpatient visit, typically 15 minutes	397	252	$119.34	$74.03
17000 Destruction of skin growth	324	239	$92.24	$53.68
88341 Special stained specimen slides to examine tissue	160	93	$92.63	$76.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	147	97	$87.93	$44.38
11100 Biopsy of single growth of skin and/or tissue	105	96	$162.87	$99.23
17110 Destruction of up to 14 skin growths	90	77	$145.62	$110.93
99202 New patient office or other outpatient visit, typically 20 minutes	82	82	$119.99	$76.12
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	72	55	$136.81	$101.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	69	69	$152.07	$109.69
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	47	35	$100.00	$74.94
17004 Destruction of precancer skin growth, 15 or more growths	45	43	$291.62	$146.36
11101 Biopsy of each additional growth of skin and/or tissue	39	31	$56.30	$33.80
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	22	21	$100.00	$76.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	10,765	6,128	$112.62	$50.42
88312 Special stained specimen slides to identify organisms including interpretation and report	8,974	2,036	$136.24	$90.34
17003 Destruction of precancer skin growth, 2-14 growths	1,142	182	$15.00	$5.41
99213 Established patient office or other outpatient visit, typically 15 minutes	451	252	$121.01	$70.56
88342 Special stained specimen slides to examine tissue, initial procedure	449	408	$104.63	$89.70
88313 Special stained specimen slides to examine tissue including interpretation and report	304	86	$89.67	$63.97
17000 Destruction of skin growth	294	206	$90.00	$51.01
88341 Special stained specimen slides to examine tissue	166	84	$81.82	$71.59
11100 Biopsy of single growth of skin and/or tissue	102	92	$175.00	$95.64
99202 New patient office or other outpatient visit, typically 20 minutes	79	79	$122.47	$72.25
17110 Destruction of up to 14 skin growths	62	55	$135.00	$97.72
17004 Destruction of precancer skin growth, 15 or more growths	49	35	$320.00	$144.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$141.26	$102.96
88304 Pathology examination of tissue using a microscope, moderately low complexity	47	34	$166.63	$38.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	34	$92.24	$41.88
11101 Biopsy of each additional growth of skin and/or tissue	39	27	$75.00	$31.98
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	28	21	$100.00	$87.44
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	26	23	$100.00	$68.08
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	24	19	$325.00	$260.91
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	17	15	$100.00	$86.16

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License UT 7247463-1204

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License WI 47784-021

Hospital & Practice Group Affiliations

Arizona Desert Dermatology And Surgery Pc

2091 N Smoketree Ave, Lake Havasu City, AZ 864035896

Phone: 9284533332

Springville Dermatology And Diagnostics Pc

732 N Main St, Springville, UT 846631034

Phone: 8017047001

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Michael Eyre

Dermatology - MOHS-Micrographic Surgery

NPI 1063481646

Dr. Warren Peterson , DO

Dermatology

NPI 1134198807

Doctor of Osteopathic Medicine (D.O.)

Shannon Smalley

Specialist

NPI 1609300383

Dr. Chad Peterson , DO

Dermatology - MOHS-Micrographic Surgery

NPI 1821299751

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

📍

Updated Business Mailing Address April 13, 2018

Registered at 732 N MAIN ST, SPRINGVILLE, UT 846631034 (Tel: 8017047001)

✅

NPI Profile Active January 10, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location January 10, 2013

Registered at 114 EAST 800 NORTH, SPANISH FORK, UT 84660 (Tel: 8017941490)

📍

Updated Business Mailing Address January 10, 2013

Registered at 114 EAST 800 NORTH, SPANISH FORK, UT 84660 (Tel: 8017941490)

👤

Provider Name / Credentials Updated January 10, 2013

Recorded as MICHAEL PETERSON, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 10, 2013

Dermatology (License #7247463-1204 in UT)

🟢

Initial NPI Registration & Enumeration January 15, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770634909

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 15, 2007

Last Update: April 13, 2018

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

732 N Main St

Springville, UT 846631034

Phone: 8017047001

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.