Pediatric Gastroenterology Department Of University Of Utah
Pediatrics, Pediatric Gastroenterology in Salt Lake City, UT. Organization (NPI-2).
NPI number1609820232
StatusActive
Last updated in NPPESSep 6, 2011
Details
- NPI
- 1609820232
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Gastroenterology Department Of University Of Utah
- Organization subpart
- No
- Enumeration date
- May 19, 2006
- Last updated
- Sep 6, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0206X | Pediatrics, Pediatric Gastroenterology | – | – | Yes |
| 208000000X | Pediatrics | – | – |
Practice location
100 N Medical DrSalt Lake City, UT 84113-1103
Phone 801-588-3370 · Fax 801-588-2375
Mailing address
295 Chipeta WayPeds Admin
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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