DEREK PETERSEN, PA-C
Physician Assistant
Active
Individual
NPI: 1104365113
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | 10232646-1206 (UT) |
Frequently Asked Questions
NPI 1104365113 is the National Provider Identifier for DEREK PETERSEN, PA-C, a Physician Assistant provider located in Ogden, UT. This NPI was enumerated on February 23, 2017.
DEREK PETERSEN, PA-C practices at 2240 ADAMS AVE, Ogden, UT 84401.
Quick Facts
- NPI
- 1104365113
- Type
- Individual
- Enumerated
- Feb 23, 2017
- Last Updated
- Feb 3, 2026
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