Individual
DR. MIKIO OBAYASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1915 W 5950 S, ROY, UT 84067-1454
(801) 387-8100
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-8100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
973396981205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053441873
—
UT
Enumeration date
07/15/2006
Last updated
08/07/2008
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