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Organization

PRIMARY CHILDREN'S MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD CLARK M.D. (CHAIR OF PEDIATRICS)
(810) 662-1000
Entity
Organization

Contact information

Practice address
100 N MEDICAL DR, PRIMARY CHILDREN'S MEDICAL CENTER PEDIATRIC CARDIOLOGY, SALT LAKE CITY, UT 84113-1103
(810) 662-5400
(801) 662-5404
Mailing address
100 N MEDICAL DR, PRIMARY CHILDREN'S MEDICAL CENTER PEDIATRIC CARDIOLOGY, SALT LAKE CITY, UT 84113-1103
(801) 662-5400
(801) 662-5404

Taxonomy

Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
6138575-1204
UT

Other

Enumeration date
05/22/2008
Last updated
05/22/2008
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