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Individual

MATTHEW S ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1954 FORT UNION BLVD STE 114, SALT LAKE CITY, UT 84121-6899
(800) 594-5736
Mailing address
1954 FORT UNION BLVD STE 114, SALT LAKE CITY, UT 84121-6899
(800) 594-5736

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
277906-4406
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107013910101
IHC
UT
01
190683600
US DEPT OF LABOR
UT
01
27760944000001
BCBS
UT
01
70918
PEHP
UT
01
774664
DESERET MUTUAL
UT
01
79200
HEALTHY U
UT
01
870666269MAT
EDUCATORS MUTUAL
UT
01
QM0000054865
ALTIUS
UT
01
TPRA06823
MOLINA
UT
Enumeration date
09/16/2006
Last updated
09/24/2007
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