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Individual

DR. NICHOLAS B. AIZCORBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 581-2121
Mailing address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 581-2121

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
LL84199
SC
2080P0202X
Pediatric Cardiology Physician
Primary
13289379-1205
UT

Other

Enumeration date
05/28/2020
Last updated
03/07/2023
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