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Individual

DR. LAUREL A FEDOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-3382
(801) 387-3259
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-7950
(801) 387-7955

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14794
NH
207R00000X
Internal Medicine Physician
7812473-1205
UT
208M00000X
Hospitalist Physician
Primary
7812473-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00988893
MEDICARE RAILROAD
UT
Enumeration date
05/04/2007
Last updated
05/07/2017
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