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Individual

DR. JOSHUA GRAHAM BURKHARDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
555 W SR 164, SALEM, UT 84653
(801) 226-3600
(801) 224-3811
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941

Taxonomy

Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
10764222-1204
UT
208000000X
Pediatrics Physician
036-137661
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036137661
IL
Enumeration date
07/05/2012
Last updated
11/27/2023
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