Individual
MICHAEL S ROUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN SURGEON
Contact information
Practice address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(801) 299-3781
(201) 299-2416
Mailing address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(801) 299-3781
(201) 299-2416
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
5349062 8905
CA
2084P0800X
Psychiatry Physician
Primary
5349062-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
—
05
—
876000308007
—
UT
Enumeration date
07/12/2006
Last updated
10/31/2013
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