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Individual

MARY E BRIESKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
360 E 4500 S STE 4, SALT LAKE CITY, UT 84107-4297
(801) 266-0055
(801) 266-0056
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 554-9300
(843) 566-8780

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
3842
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870326048001D7226
UT
05
MD3842
AK
Enumeration date
09/28/2005
Last updated
03/03/2008
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