Individual
BERT K LOPANSRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 C ST, SALT LAKE CITY, UT 84143-1005
(801) 408-2293
Mailing address
5171 S COTTONWOOD ST, MURRAY, UT 84107-5704
(801) 507-7781
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
30825861205
UT
Other
Enumeration date
09/02/2006
Last updated
04/30/2021
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