Individual
NATHAN C MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
6028 S RIDGELINE DR, STE 201, OGDEN, UT 84405-6914
(801) 475-5400
(801) 475-8614
Mailing address
PO BOX 337, LAYTON, UT 84041-0337
(801) 773-4840
(801) 525-8151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2854591206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107004880101
IHC
UT
05
—
87065316400Z
—
UT
Enumeration date
10/07/2005
Last updated
08/17/2020
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