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Individual

DR. MAXIMILIAN PSOLKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4878 S HIGHLAND DR, HOLLADAY, UT 84117-6007
(801) 272-8861
Mailing address
4878 S HIGHLAND DR, HOLLADAY, UT 84117-6007
(801) 272-8861

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01047658A
IN
207W00000X
Ophthalmology Physician
1143296-1205
UT
207W00000X
Ophthalmology Physician
D70499
MD
207W00000X
Ophthalmology Physician
Primary
MD61291718
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036676500
MD
Enumeration date
08/30/2006
Last updated
05/04/2022
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