Individual
NATHAN A. WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
PO BOX 581700, SALT LAKE CITY, UT 84158-1700
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5210736-1205
UT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
5210736-1205
UT
208M00000X
Hospitalist Physician
Primary
5210736-1205
UT
Other
Enumeration date
11/03/2006
Last updated
12/16/2021
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