Individual
DR. MICHAEL E MATLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N MARIO CAPECCHI DR, SUITE 2600, SALT LAKE CITY, UT 84113-1103
(801) 662-2950
(801) 662-2980
Mailing address
100 N MARIO CAPECCHI DR, SUITE 2600, SALT LAKE CITY, UT 84113-1103
(801) 662-2950
(801) 662-2980
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1605921205
UT
2086S0120X
Pediatric Surgery Physician
Primary
1605921205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05572
—
UT
Enumeration date
10/18/2006
Last updated
06/02/2008
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