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Individual

RICHARD G MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3741 W 12600 S, RIVERTON HOSPITAL, RIVERTON, UT 84065
(801) 285-4000
(801) 733-5618
Mailing address
3340 NORTH CENTER ST, #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
380672-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100501251
NV
01
1070146632101
IHC
UT
05
118872100
WY
01
2090168
UNITED HEALTHCARE
UT
01
38067212001001
BCBS
UT
01
75172
PEHP
UT
05
806442900
ID
05
820169
AZ
01
8221004
DESERET MUTUAL
UT
01
870545614MA4
EDUCATORS MUTUAL
UT
01
QM0000075886
ALTIUS
UT
01
TPRA07189
MOLINA
UT
Enumeration date
09/01/2006
Last updated
10/15/2012
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