DR. Willard Dere, M.D.

NPI #1003286758 in Salt Lake City, Utah

Provider Information

NPI Number: 1003286758
Entity Type: Individual
Name: DR. Willard Dere, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Internal Medicine
Credential: M.D.
Enumeration Date: Oct 6, 2015
Last Updated: Oct 6, 2015

Practice Location

Address: 500 FOOTHILL BLVD
City: Salt Lake City
State: Utah
ZIP Code: 84148-0001
Phone: (801) 582-1565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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