Organization
MATERNAL FETAL SERVICES OF UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. KANE (VP)
(801) 568-5999
Entity
Organization
Contact information
Practice address
1140 E 3900 S, SUITE 390, SALT LAKE CITY, UT 84124-1228
(801) 743-4700
(801) 743-4705
Mailing address
1140 E 3900 S, SUITE 390, SALT LAKE CITY, UT 84124-1228
(801) 743-4700
(801) 743-4705
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121073400
—
WY
05
—
1457393084
—
NV
05
—
1457393084
—
VA
05
—
200134000A
—
OK
05
—
60271256
—
CO
05
—
807101900
—
ID
Enumeration date
06/11/2006
Last updated
05/20/2010
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