Individual
DR. MARK R. ELSTAD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
VA MEDICAL CENTER, 500 FOOTHILL DRIVE, SALT LAKE CITY, UT 84148-0001
(801) 584-5603
Mailing address
4596 FORTUNA WAY, SALT LAKE CITY, UT 84124-4768
(801) 272-3740
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
170754-1205
UT
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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