Individual
MICHAEL ANDREW GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5872 S 900 E, #100, SALT LAKE CITY, UT 84121-1676
(801) 262-3443
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 262-3443
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2857011206
UT
Other
Enumeration date
08/08/2006
Last updated
10/18/2007
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