Individual
TAKIKO M MAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(406) 363-2211
(406) 375-4672
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 716-1000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19534
MT
207R00000X
Internal Medicine Physician
MD25008
OR
208M00000X
Hospitalist Physician
19534
MT
208M00000X
Hospitalist Physician
Primary
8656652-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952338121
—
ID
05
—
1952338121
—
MT
01
—
M011002935
MEDICARE PTAN
MT
Enumeration date
06/26/2006
Last updated
07/21/2022
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