Individual
MICHELLE MEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 587-7400
Mailing address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
10957195-1205
UT
2080P0205X
Pediatric Endocrinology Physician
Primary
10957195-1205
UT
Other
Enumeration date
04/12/2017
Last updated
10/04/2023
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