Organization
MATTHEW O LEAVITT MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW O LEAVITT MD (PHYSICIAN)
(801) 225-5409
Entity
Organization
Contact information
Practice address
945 S OREM BLVD, OREM, UT 84058-5011
(801) 225-5407
(801) 225-5623
Mailing address
PO BOX 1442, PROVO, UT 84603-1442
(801) 225-5407
(801) 225-5623
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
65908671205
UT
207ZD0900X
Dermatopathology (Pathology) Physician
65908671205
UT
207ZI0100X
Immunopathology Physician
65908671205
UT
207ZN0500X
Neuropathology Physician
65908671205
UT
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
65908671205
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
65908671205
UT
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
65908671205
UT
Other
Enumeration date
09/19/2007
Last updated
06/10/2008
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