Organization
DEPARTMENT OF NEUROLOGY SCHOOL OF MEDICINE UNIVERSITY OF UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEFAN PULST MD (DEPARTMENT CHAIR)
(801) 585-6387
Entity
Organization
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 585-6387
Mailing address
PO BOX 413027, SALT LAKE CITY, UT 84141-3027
(801) 236-7748
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003060200
—
ID
05
—
100502570
—
NV
05
—
122358500
—
WY
05
—
807423300
—
ID
Enumeration date
05/20/2006
Last updated
10/19/2011
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