Provider Demographics
NPI:1144229931
Name:MOSKOWITZ, PETER KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:KENNETH
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7929 S FOREST OAKS CT
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-5737
Mailing Address - Country:US
Mailing Address - Phone:801-274-0317
Mailing Address - Fax:801-210-5350
Practice Address - Street 1:6360 S 3000 E
Practice Address - Street 2:STE 230
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-6923
Practice Address - Country:US
Practice Address - Phone:801-523-3030
Practice Address - Fax:801-523-3033
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2015-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3471031205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics