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Individual

CHARLES J PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1950 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5500
(801) 581-2121
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
(801) 213-3900

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
173510-1205
UT
207RH0000X
Hematology (Internal Medicine) Physician
Primary
173510-1205
UT
207RH0003X
Hematology & Oncology Physician
173510-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003038700
ID
05
100505612
NV
05
122435200
WY
01
231906
ALTIUS #
01
81912
PEHP #
01
879789
UNIVERSITY HEALTH PLANS #
01
887304
DMBA #
05
D5987
UT
Enumeration date
05/11/2006
Last updated
11/10/2021
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