Organization
PROFESSIONAL DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FJELDSTED MD (PRESIDENT)
(800) 288-8325
Entity
Organization
Contact information
Practice address
1050 E SOUTH TEMPLE, SALT LAKE CITY, UT 84102-1507
(800) 288-8325
(419) 866-5453
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/26/2006
Last updated
01/28/2020
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