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Individual

MICHAEL J SLYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1954 FORT UNION BLVD STE 114, SALT LAKE CITY, UT 84121-6899
(800) 594-5736
Mailing address
1954 FORT UNION BLVD STE 114, SALT LAKE CITY, UT 84121-6899
(800) 594-5736

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
308294-4406
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107027629101
IHC
UT
01
30829444000001
BCBS
UT
01
59334
HEALTHY U
UT
01
77634
PEHP
UT
01
850801
DESERET MUTUAL
UT
01
QM0000054865
ALTIUS
UT
01
TPRA10458
MOLINA
UT
Enumeration date
09/16/2006
Last updated
09/24/2007
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