Intermountain Medical Group Grand Junction, LLC
Internal Medicine, Hypertension Specialist in Moab, UT. Organization (NPI-2).
NPI number1346854130
StatusActive
Last updated in NPPESJun 28, 2024
Details
- NPI
- 1346854130
- Entity type
- Organization (NPI-2)
- Legal business name
- Intermountain Medical Group Grand Junction, LLC
- Organization subpart
- Yes
- Enumeration date
- Aug 31, 2020
- Certification date
- Jun 28, 2024
- Last updated
- Jun 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RH0005X | Internal Medicine, Hypertension Specialist | – | – | Yes |
Other names
- Moab Neurology Satellite Clinic (Doing Business As)
Practice location
476 Williams WayMoab, UT 84532-2186
Phone 435-719-5550 · Fax 435-719-5501
Mailing address
476 Williams WayMoab, UT 84532-2186
Phone 435-719-5550 · Fax 435-719-5501
Authorized official
Jon McDaniel
Vp Finance Medical Group
3032720231
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