Individual
MICHAEL JOHN MIESCIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1234
Mailing address
PO BOX 413021, SALT LAKE CITY, UT 84141-3021
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
327414-1205
UT
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
327414-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124108519
—
UT
Enumeration date
10/17/2006
Last updated
03/08/2022
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