Individual
DR. ALEXANDER LORENZO COLONNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0100
(801) 581-7738
Mailing address
PO BOX 413035, SALT LAKE CITY, UT 84141-3035
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
8211264-1205 MD
UT
2086S0102X
Surgical Critical Care Physician
8211264-1205 MD
UT
2086S0127X
Trauma Surgery Physician
8211264-1205 MD
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000042209
MEDICAL LICENSE
TN
01
—
2008-00832
MEDICAL LICENSE
NC
01
—
8211264-1205 MD
UTAH MEDICAL LICENSE
UT
Enumeration date
09/26/2007
Last updated
11/12/2021
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