Individual
KAREN ANNE DITTRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5444 S. GREEN ST., MURRAY, UT 84123-5632
(801) 262-8120
(801) 262-3897
Mailing address
5444 S. GREEN ST., MURRAY, UT 84123-5632
(801) 262-8120
(801) 262-3897
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
185077-1205
UT
2085R0202X
Diagnostic Radiology Physician
M-11469
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003814013
REGENCE BCBSUT
UT
01
—
103721
PEHP
UT
01
—
107005898103
SELECTHEALTH
UT
01
—
107005898106
SELECTHEALTH
UT
05
—
120442400
—
WY
01
—
311802
DESERET MUTUAL BENEFITS ADMINISTRATORS
UT
05
—
807039500
—
ID
05
—
D0076
—
UT
01
—
P00041680
RAILROAD MEDICARE
UT
01
—
P00616149
RAILROAD MEDICARE
UT
Enumeration date
07/13/2005
Last updated
08/30/2012
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