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Individual

HARRY O SENEKJIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4403 HARRISON BLVD, SUITE 2635, OGDEN, UT 84403-3244
(801) 387-6820
(801) 387-6825
Mailing address
4403 HARRISON BLVD, SUITE 2635, OGDEN, UT 84403-3244
(801) 387-6820
(801) 387-6825

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
169315 1205
UT
207RN0300X
Nephrology Physician
Primary
169315
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000060400
IDAHO MEDICAID
UT
01
0400649
UHC
UT
05
07331
UT
01
107004821101
IHC
UT
01
110234858
PALMETTO RR INS
UT
01
1167014 00
ACS
UT
05
1760484596
UT
01
31896
GEM STATE
UT
01
68391
PEHP
UT
01
8445
DMBA
UT
01
PR00533
MOLINA
UT
01
QM0000056196
ALTIUS
UT
Enumeration date
08/11/2005
Last updated
08/15/2016
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