Organization
SAGE DERMATOLOGY AND MOHS SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA BRIMHALL DO (OWNER)
(216) 280-1875
Entity
Organization
Contact information
Practice address
11760 S 700 E STE 112, DRAPER, UT 84020-6605
(216) 280-1875
Mailing address
2932 N 1130 W, PLEASANT GROVE, UT 84062-8055
(216) 280-1875
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3011678
—
UT
Enumeration date
11/24/2023
Last updated
12/15/2023
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