Individual
DR. ANNE JEANNETT BLASCHKE-BONKOWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 581-6791
(801) 585-6817
Mailing address
295 CHIPETA WAY, PEDS ADMIN, SALT LAKE CITY, UT 84108-1220
(801) 581-6791
(801) 585-6817
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4979066-1205
UT
2080P0208X
Pediatric Infectious Diseases Physician
Primary
4979066-1205
UT
Other
Enumeration date
05/17/2006
Last updated
10/28/2021
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