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Individual

DR. CONSTANCE K MAVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1900
(801) 662-1810
Mailing address
869 E 4500 S, PMB 511, SALT LAKE CITY, UT 84107-3049
(801) 487-0451
(801) 487-2467

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
5010881-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1070011544101
SELECTHEALTH
UT
01
1600468
UNITED HEALTHCARE
UT
01
31853
UUHN
UT
01
35834
DESERET MUTUAL
UT
01
50108811200001
BLUE SHIELD
UT
01
67154
PUBLIC EMPLOYEES HEALTH
UT
01
8550895
AETNA
UT
01
870355724MAV
EDUCATORS MUTUAL
UT
01
QM0000027099
ALTIUS
UT
Enumeration date
09/26/2006
Last updated
06/17/2008
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