Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 169644-1205 | UT |
NPI | 1285673434 |
---|---|
Provider Name | Dr. David James Peifer |
First Address | Salt Lake City, UT 84124-3417 |
Second Address | Salt Lake City, UT 84148-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
UAD000 | (02) | UT |