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Organization
NOVACEL
Active
Organization
NOVACEL
Active
Other names
Novacel
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANA ANDERSON-OMINSKI (BILLING DIRECTOR)
(801) 888-1140
Entity
Organization
Contact information
Practice address
4624 S HOLLADAY BLVD STE 201, SALT LAKE CITY, UT 84117-7168
(018) 266-3113
(801) 266-5633
Mailing address
4624 S HOLLADAY BLVD STE 201, SALT LAKE CITY, UT 84117-7168
(801) 438-8280
(801) 438-8747
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790243111
NPI
UT
Enumeration date
03/05/2019
Last updated
08/16/2019
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