Individual
DR. MICHAEL J DOERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
395 W BULLDOG BLVD FL 6, PROVO, UT 84604-3311
(801) 357-0570
(801) 357-7198
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6679446-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548645195
—
UT
Enumeration date
07/24/2015
Last updated
01/16/2019
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