Organization
NATHAN G MOMBERGER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE R OAKES CPA (BUSINESS ADMINISTRATOR)
(801) 314-5026
Entity
Organization
Contact information
Practice address
5848 FASHION BLVD STE 110, SALT LAKE CITY, UT 84107-6121
(801) 314-5026
(801) 314-4015
Mailing address
5848 FASHION BLVD STE 110, SALT LAKE CITY, UT 84107-6121
(801) 314-5026
(801) 314-4015
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
3208681205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528299949009
—
UT
Enumeration date
12/05/2007
Last updated
11/10/2010
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