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Organization
BMT DIVISION DEPARTMENT OF UNIVERSITY OF UTAH
Active
Organization
BMT DIVISION DEPARTMENT OF UNIVERSITY OF UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANELL I MADONNA (DIRECTOR OF CONTRACTING AND PE)
(801) 587-6464
Entity
Organization
Contact information
Practice address
1950 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5500
(801) 581-2121
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-0001
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RH0000X
Hematology (Internal Medicine) Physician
—
NULL
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
Primary
—
NULL
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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