Individual
BRIAN J. MOENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 C ST, SALT LAKE CITY, UT 84143-1005
(801) 993-9582
(801) 733-5618
Mailing address
2975 EXECUTIVE PKWY, 200, LEHI, UT 84043-9642
(801) 990-1911
(801) 990-1912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
166534-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107005585102
IHC
UT
01
—
1502954
UMWA
UT
01
—
20835
DESERET MUTUAL
UT
01
—
66119
PEHP
UT
01
—
702
HEALTHY U
UT
05
—
820309
—
AZ
01
—
QM0000075886
ALTIUS
UT
01
—
TPRA07309
MOLINA
UT
Enumeration date
08/07/2006
Last updated
07/08/2007
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