Organization
SKIN PATHOLOGY CONSULTANTS OF UTAH
Active
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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