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Individual
LOYAL J PACE
Active
Individual
LOYAL J PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
81-166495-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107004984101
IHC
UT
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
3517
HEALTHY U
UT
01
—
36136
DESERET MUTUAL
UT
01
—
37809
PEHP
UT
05
—
383563
—
AZ
01
—
8597445
WORKERS COMP FUND
UT
01
—
870545614PA2
EDUCATORS MUTUAL
UT
01
—
PRA02896
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
08/08/2006
Last updated
07/08/2007
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