Individual
DR. DEREK WILLIAM GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N MARIO CAPECCHI RM 2S100, SALT LAKE CITY, UT 84112
(801) 581-2121
Mailing address
30 N MARIO CAPECCHI RM 2S100, SALT LAKE CITY, UT 84112
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
14212374-1205
UT
2085R0202X
Diagnostic Radiology Physician
0101258688
VA
2085R0202X
Diagnostic Radiology Physician
Primary
14212374-1205
UT
208D00000X
General Practice Physician
0116027479
VA
Other
Enumeration date
03/27/2014
Last updated
03/06/2026
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