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Organization
ELENA L GONCHAROVA MD PC
Active
Organization
ELENA L GONCHAROVA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA L GONCHAROVA MD (PRESIDENT)
(801) 475-5100
Entity
Organization
Contact information
Practice address
425 E 5350 S, STE 335, OGDEN, UT 84405-6946
(801) 475-5100
(801) 475-8580
Mailing address
PO BOX 150610, OGDEN, UT 84415-0610
(801) 476-9200
(801) 476-9208
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53786511205
UT
Other
Enumeration date
06/19/2007
Last updated
05/21/2020
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