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Pediatric Pulmonology Department Of University Of Utah

Pediatrics, Pediatric Pulmonology in Salt Lake City, UT. Organization (NPI-2).

NPI number1255428314
StatusActive
Last updated in NPPESSep 6, 2011

Details

NPI
1255428314
Entity type
Organization (NPI-2)
Legal business name
Pediatric Pulmonology Department Of University Of Utah
Organization subpart
No
Enumeration date
Oct 9, 2006
Last updated
Sep 6, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0214X Pediatrics, Pediatric Pulmonology––Yes
208000000X Pediatrics––

Practice location

100 N Medical Dr
Pediatric Pulmonology
Salt Lake City, UT 84113-1103

Phone 801-588-2621 · Fax 801-588-2640

Mailing address

295 Chipeta Way
U Of U Som Dept Of Pediatrics
Salt Lake City, UT 84108-1220

Phone 801-587-7400 · Fax 801-587-7417

Authorized official

Edward B Clark
Chair
8015877400

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