Individual
DR. ROLAND PAGE DIMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 S 900 E, SALT LAKE CITY, UT 84105-3208
(801) 464-7600
(801) 464-7656
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 464-7600
(801) 464-7656
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
48194351205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942854057090
—
UT
Enumeration date
05/20/2006
Last updated
06/26/2009
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