Individual
DR. ANDREW FEDORAVICIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6360128-1205
UT
207RG0100X
Gastroenterology Physician
Primary
6360128-1205
UT
208M00000X
Hospitalist Physician
7471341-1205
UT
Other
Enumeration date
08/30/2007
Last updated
03/04/2025
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