Individual
MICHELLE THERESA PAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2000 S 900 E, SALT LAKE CITY, UT 84105-3208
(801) 464-7777
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 464-7777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9679442-1205
UT
207R00000X
Internal Medicine Physician
MD2009-0018
NM
208000000X
Pediatrics Physician
9679442-1205
UT
208000000X
Pediatrics Physician
MD2009-0018
NM
208M00000X
Hospitalist Physician
9679442-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87577747
—
NM
01
—
NM302250
MEDICARE PTAN
—
Enumeration date
04/11/2007
Last updated
05/24/2017
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