Individual
DR. D EDWARD MINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124-1300
(801) 268-7111
Mailing address
PO BOX 1369, BOUNTIFUL, UT 84011-1369
(801) 296-2113
(801) 296-1715
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
152665-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002087689
—
NV
05
—
003812200
—
ID
05
—
04348
—
UT
05
—
120732600
—
WY
05
—
927741
—
AZ
01
—
P00651547
RR MEDICARE
UT
Enumeration date
07/26/2005
Last updated
02/12/2009
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