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Individual

MICHAEL S. MCBAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHARMD

Contact information

Practice address
250 E 200 S RM 1202, SALT LAKE CITY, UT 84111-2472
(801) 581-3841
Mailing address
250 E 200 S RM 1202, SALT LAKE CITY, UT 84111-2472
(801) 581-3841

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
183500000X
Pharmacist
PH00039885
WA
2083X0100X
Occupational Medicine Physician
Primary
12994430-1205
UT
208D00000X
General Practice Physician
MD60502221
WA

Other

Enumeration date
02/15/2007
Last updated
08/23/2022
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