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Individual

DR. TODD B ENGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 379-2900
(801) 374-6295
Mailing address
1735 N STATE ST, SUITE 201, PROVO, UT 84604-1010
(801) 379-2900
(801) 374-6295

Taxonomy

Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
3591001205
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
983591001205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0880213
UNITED HEALTHCARE
UT
01
107007206102
SELECT HEALTH
UT
01
1146594
AFFORDABLE
UT
01
1435708001
CIGNA
UT
01
204371916TBE
EMIA
UT
01
87028357684601A001
TRICARE
UT
01
87028357684604C001
PGBA
UT
01
QM0000053146
ALTIUS
UT
Enumeration date
01/26/2006
Last updated
04/13/2017
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