Individual
MR. JOHN MICHAEL SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5292 SO COLLEGE DR, 202, MURRAY, UT 84123
(801) 266-3671
(801) 266-8194
Mailing address
5292 SO COLLEGE DR, 202, MURRAY, UT 84123
(801) 266-3671
(801) 266-8194
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
3557751205
UT
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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