Individual
BENJAMIN J. MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N 1900 E # 1C026, SALT LAKE CITY, UT 84132-0002
(801) 581-2417
Mailing address
30 N 1900 E # 1C026, SALT LAKE CITY, UT 84132-0002
(801) 581-2417
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12407597-1205
UT
Other
Enumeration date
03/28/2020
Last updated
09/15/2021
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