Individual
MARVIN JEREMY ASTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124-1300
(801) 993-9530
(801) 733-5618
Mailing address
1954 FORT UNION BLVD, SALT LAKE CITY, UT 84121-6800
(801) 993-9530
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5898976-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107389211101
IHC
UT
01
—
243341
ALTIUS
UT
01
—
82347
PEHP
UT
01
—
88999
HEALTHY U
UT
01
—
902487
DESERET MUTUAL
UT
01
—
QMP000002261759
MOLINA
UT
Enumeration date
09/20/2006
Last updated
07/08/2007
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