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Individual

ADAM BINNEBOESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
30 N 1900 E RM 1A71, SALT LAKE CITY, UT 84132
(605) 659-4075
Mailing address
974 E OLYMPUS PARK DRIVE, SALT LAKE CITY, UT 84117-1545
(801) 796-2264

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10077796-1205
UT
208D00000X
General Practice Physician
10077796-1205
UT

Other

Enumeration date
04/26/2015
Last updated
06/24/2024
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