Individual
CHARITY OAKS COE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
UNIVERSITY OF UTAH MEDICAL CENTER TRAUMA SERVICE, 50 NORTH MEDICAL DRIVE, SALT LAKE CITY, UT 84132-0001
(443) 690-6996
Mailing address
UNIVERSITY OF UTAH MEDICAL CENTER TRAUMA SERVICE, 50 NORTH MEDICAL DRIVE, SALT LAKE CITY, UT 84132-0001
(443) 690-6996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0003391
MD
363AS0400X
Surgical Physician Assistant
Primary
5744061-1206
UT
Other
Enumeration date
07/19/2007
Last updated
03/26/2008
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