Individual
DR. TODD ADAM MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
989 E 900 S, SUITE A1, SALT LAKE CITY, UT 84105-1473
(801) 531-8340
(801) 531-8350
Mailing address
989 E 900 S, SUITE A1, SALT LAKE CITY, UT 84105-1473
(801) 531-8340
(801) 531-8350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3399401205
UT
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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