Individual
DR. MIRIAM PECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 N 1900 E # 1C412, GME OFFICE, SALT LAKE CITY, UT 84132-2115
(801) 581-2401
(801) 585-2507
Mailing address
30 N 1900 E # 1C412, GME OFFICE, SALT LAKE CITY, UT 84132-2115
(801) 581-2401
(801) 585-2507
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
9683730-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2011
Last updated
11/11/2021
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