Individual
DR. DUSTIN EDWARD MONROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.B.A.
Contact information
Practice address
750 W 800 N, OREM, UT 84057-3660
(801) 714-6350
Mailing address
750 W 800 N, OREM, UT 84057-3660
(801) 714-6350
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
10255195-1205
UT
208000000X
Pediatrics Physician
47602
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
10255195-1205
UT
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
10255195-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825752
—
AZ
01
—
MD47602
LICENSE
AZ
Enumeration date
07/08/2010
Last updated
07/21/2022
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