Individual
EDWIN CLIFFORD MCGOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 N PIONEER FORK RD, SALT LAKE CITY, UT 84108-1642
(801) 554-9481
Mailing address
705 N PIONEER FORK RD, SALT LAKE CITY, UT 84108-1642
(801) 554-9481
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
154013-1205
UT
Other
Enumeration date
02/26/2013
Last updated
05/27/2014
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