Individual
MAREN ELISABETH BUSATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
743 E 300 S, SALT LAKE CITY, UT 84102
(801) 428-3500
Mailing address
743 E 300 S, SALT LAKE CITY, UT 84102
(801) 428-3500
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18275918
UMR
—
Enumeration date
06/01/2022
Last updated
06/01/2022
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