Dr. Bryce Donald Haslem, M.D.
Internal Medicine, Gastroenterology in Provo, UT. Individual provider (NPI-1).
NPI number1124286133
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1124286133
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bryce Donald Haslem
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 27, 2008
- Certification date
- Apr 14, 2020
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RG0100X | Internal Medicine, Gastroenterology | 9016684-1205 | UT | Yes |
| 207Q00000X | Family Medicine | 39640 | IA | |
| 207R00000X | Internal Medicine | R-8339 | IA |
Practice location
1055 N 500 W Ste 100Provo, UT 84604-3305
Phone 801-374-1268 · Fax 801-812-5454
Mailing address
1055 N 500 WAttn: Credentialing
Provo, UT 84604-3305
Phone 801-354-8225 · Fax 801-418-0941
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