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Individual

MARIANNE AUGUSTINE KAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1287
(703) 862-9076
Mailing address
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1287
(703) 862-9076

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
959965-1205
UT
208000000X
Pediatrics Physician
MT193865
PA
2080P0206X
Pediatric Gastroenterology Physician
Primary
959965-1205
UT
2080T0004X
Pediatric Transplant Hepatology Physician
959965-1205
UT

Other

Enumeration date
08/07/2008
Last updated
12/14/2021
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