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Individual

ELLIOTT ADAM KARREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Mailing address
2642 PARK AVE, SAINT LOUIS, MO 63104-2024
(314) 398-9034

Taxonomy

Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
8771572-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/11/2012
Last updated
07/21/2022
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