Organization
UNIVERSITY OF UTAH HOSPITALS AND CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN A TERRY MD (MEDICAL DIRECTOR)
(801) 587-6307
Entity
Organization
Contact information
Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1401
(801) 213-9900
Mailing address
PO BOX 510708, SALT LAKE CITY, UT 84151-0708
(801) 587-6600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505587
—
NV
05
—
121530200
—
WY
01
—
4974170001
MEDICARE DME
—
05
—
807076500
—
ID
01
—
CH7050
RAILROAD MEDICARE
UT
Enumeration date
05/19/2006
Last updated
09/07/2011
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