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Individual

LEGRAND P BELNAP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1250 E 3900 S STE 220, SALT LAKE CITY, UT 84124-1369
(801) 262-9782
(801) 262-8632
Mailing address
1250 E 3900 S STE 220, SALT LAKE CITY, UT 84124-1369
(801) 262-9782
(801) 262-8632

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4403014
CIGNA
01
52930701001001
BLUE CROSS BLUE SHIELD
01
PR01029
MOLINA
01
QM0000063898
ALTIUS
Enumeration date
07/07/2006
Last updated
01/09/2008
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