Individual
CARL EDWARD WYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5770 FASHION BLVD, MURRAY, UT 84107-6548
(801) 314-4544
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 314-4544
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
3114301205
UT
Other
Enumeration date
07/20/2006
Last updated
10/18/2007
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