Individual
MATTHEW JAMES MULLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N 1900 E, SALT LAKE CITY, UT 84132-0002
(801) 581-7606
Mailing address
30 N 1900 E RM 4C104, SALT LAKE CITY, UT 84132-0002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10492146-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2016
Last updated
05/03/2022
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