Organization
SKIN PATHOLOGY CONSULTANTS OF UTAH
Active
Other names
Dermatopathology Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA ANN VITALE MD (DIRECTOR LED)
(801) 261-3007
Entity
Organization
Contact information
Practice address
168 E 5900 S, STE C104, MURRAY, UT 84107-7287
(801) 261-3007
(801) 263-6703
Mailing address
168 E 5900 S, STE C104, MURRAY, UT 84107-7287
(801) 261-3007
(801) 263-6703
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
5228084-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140649593001
—
UT
01
—
1558466177
INDIVIDUAL NPI NUMBER
—
Enumeration date
02/05/2007
Last updated
10/29/2012
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