Organization
INTERNAL MED- HEMATOLOGY- HEMATOLOGIC DEPARTMENT OF UNIVERSITY OF UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA MORENO (PROVIDER ENROLLMENT)
(801) 587-6336
Entity
Organization
Contact information
Practice address
1950 EAST CIRCLE OF HOPE DRIVE, SALT LAKE CITY, UT 84112-5550
(801) 213-3800
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
—
UT
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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