Individual
WANDA S UPDIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1060 E 100 S, L10, SALT LAKE CITY, UT 84102
(801) 328-1260
(801) 350-4361
Mailing address
1060 E 100 S, L10, SALT LAKE CITY, UT 84102
(801) 328-1260
(801) 350-4361
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1738441205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
801401924005
—
UT
Enumeration date
02/22/2006
Last updated
02/09/2010
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