Organization
WESTERN NEWBORN SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN LIU MD (V PRESIDENT)
(801) 296-2113
Entity
Organization
Contact information
Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124
(801) 296-2113
(801) 951-2389
Mailing address
PO BOX 520691, SALT LAKE CITY, UT 84152
(801) 296-2113
(801) 951-2389
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13593400144
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118584500
—
WY
05
—
1841271558
—
UT
Enumeration date
11/09/2005
Last updated
11/02/2011
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