# MOUNTAIN TOP MEDICAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235783994
- **Authorized official:** MICHAEL C SHAW MD (CO-OWNER)
- **Authorized official phone:** (435) 515-3030

## Contact information

- **Practice address:** 140 E 1000 S STE B2, BRIGHAM CITY, UT 84302-4399
- **Practice address phone:** (435) 515-3030
- **Practice address fax:** (435) 515-3434
- **Mailing address:** 140 E 1000 S STE B2, BRIGHAM CITY, UT 84302-4399
- **Mailing address phone:** (435) 515-3030
- **Mailing address fax:** (435) 515-3434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2019
- **Last updated:** 07/30/2019