Individual
FATIMA GANGOTENA-BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
144 S 500 E, SALT LAKE CITY, UT 84102-1907
(801) 783-5011
Mailing address
144 S 500 E, SALT LAKE CITY, UT 84102-1907
(801) 783-5011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7748728-1205
UT
Other
Enumeration date
10/28/2008
Last updated
09/01/2016
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