Individual
DR. ANDREW MACKAY BREIVIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Mailing address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12751732-1205
UT
207R00000X
Internal Medicine Physician
DR.0067961
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2019
Last updated
11/21/2022
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