Unknown Individual – Adolescent Medicine (Internal Medicine) Physician, NPI 1053369942
Adolescent Medicine (Internal Medicine) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 413021
SALT LAKE CITY, UT 841413021
Phone: (801) 213-3900
Fax: (801) 585-9410
Type: Mailing
50, North Medical Drive, Salt Lake City, Salt Lake County, Utah, 84113, United States
SALT LAKE CITY, UT 841320100
Phone: (801) 585-2150
Fax: (801) 585-9410
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84141)
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