Organization
HIGHLAND MEDICAL PLLC
Active
Other names
Highland Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK DAVID MUSE MD (MANAGER)
(801) 272-4111
Entity
Organization
Contact information
Practice address
4460 HIGHLAND DR, STE 400, SALT LAKE CITY, UT 84124-3565
(801) 272-4111
(801) 272-5989
Mailing address
4460 SO HIGHLAND DR, #400, SALT LAKE CITY, UT 84124
(801) 272-4111
(801) 272-5989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1045691206
UT
207Q00000X
Family Medicine Physician
Primary
1813021205
UT
207Q00000X
Family Medicine Physician
2763721206
UT
207Q00000X
Family Medicine Physician
2879974405
UT
207Q00000X
Family Medicine Physician
3484061205
UT
207Q00000X
Family Medicine Physician
3655121205
UT
305R00000X
Preferred Provider Organization
1813021205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528940093006
—
UT
Enumeration date
10/23/2006
Last updated
03/10/2008
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