Individual
DR. MARY LOUISE SYDNEY LEGUYADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
5169 S COTTONWOOD ST, SALT LAKE CITY, UT 84107-6767
(801) 507-3310
Mailing address
5169 S COTTONWOOD ST, SALT LAKE CITY, UT 84107-6767
(801) 507-3310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10490279-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2016
Last updated
05/14/2019
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