Individual provider · NPI-1

Dr. Anne Jeannett Blaschke-Bonkowsky, MD

Pediatrics, Pediatric Infectious Diseases · Salt Lake City, UT

NPI number1760435325
StatusActive
Last updated in NPPESOct 28, 2021

Details

NPI
1760435325
Entity type
Individual (NPI-1)
Name
Dr. Anne Jeannett Blaschke-Bonkowsky
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
May 17, 2006
Certification date
Oct 28, 2021
Last updated
Oct 28, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0208X Pediatrics, Pediatric Infectious Diseases4979066-1205UTYes
208000000X Pediatrics4979066-1205UT

Practice location

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

Phone 801-581-6791 · Fax 801-585-6817

Mailing address

295 Chipeta Way
Peds Admin
Salt Lake City, UT 84108-1220

Phone 801-581-6791 · Fax 801-585-6817

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