Individual
DR. TANIA PATRICIA NISIMBLAT BODNAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 ROUND VALLEY DR STE 200, PARK CITY, UT 84060-7552
(435) 658-7400
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
056880546
CT
207V00000X
Obstetrics & Gynecology Physician
Primary
10757475-1205
UT
Other
Enumeration date
02/06/2009
Last updated
11/11/2024
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