Individual
MICHAEL DAVID ENGELBERT-FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
150 S 1000 E, SALT LAKE CITY, UT 84102-1443
(801) 363-4071
Mailing address
6275 SNOWVIEW DR, PARK CITY, UT 84098-6118
(435) 645-7852
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
102950-1206
UT
363AM0700X
Medical Physician Assistant
Primary
102950-1206
UT
Other
Enumeration date
12/22/2005
Last updated
09/14/2021
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