Individual
DR. EDMUND A LILES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-7085
(801) 581-2121
Mailing address
30 N 1900 E # 5R218, SALT LAKE CITY, UT 84132-0002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12777047-1205
UT
207R00000X
Internal Medicine Physician
9701460
NC
208M00000X
Hospitalist Physician
Primary
12777047-1205
UT
208M00000X
Hospitalist Physician
9701460
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891256A
—
NC
Enumeration date
07/13/2006
Last updated
08/12/2022
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