Individual
MARY ANN MCCUMBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1050 E SOUTH TEMPLE, SALT LAKE CITY, UT 84102-1507
(801) 350-4631
Mailing address
1050 E SOUTH TEMPLE, SALT LAKE CITY, UT 84102-1507
(801) 350-4631
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H0072507
MD
207P00000X
Emergency Medicine Physician
OT012356
PA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5082124-1204
UT
Other
Enumeration date
05/24/2008
Last updated
08/21/2014
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