Samuel Rush Osimitz
Physician Assistant in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1013590785
StatusActive
Last updated in NPPESMay 2, 2023
Details
- NPI
- 1013590785
- Entity type
- Individual (NPI-1)
- Name
- Samuel Rush Osimitz
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 30, 2021
- Certification date
- May 2, 2023
- Last updated
- May 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 10705102-1206 | UT | Yes |
Practice location
375 S Chipeta WaySalt Lake City, UT 84108-1260
Phone 801-581-7766
Mailing address
375 S Chipeta WaySalt Lake City, UT 84108-1260
Phone 801-581-7766
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