Pediatric Adolescent Medicine Department of Univeristy of Utah

NPI #1639123896 in Salt Lake City, Utah

Provider Information

NPI Number
1639123896
Entity Type
Organization
Organization Name
Pediatric Adolescent Medicine Department of Univeristy of Utah
Primary Specialty
Pediatrics - Adolescent Medicine
Enumeration Date
May 20, 2006
Last Updated
Sep 6, 2011

Practice Location

Address
50 N MEDICAL DR
State
Utah
ZIP Code
84132-0001
Phone
(801) 581-3501

Authorized Official

Name
DR. EDWARD B CLARK, MD
Title
CHAIR
Phone
(801) 587-7400

Specialties & Taxonomy Codes

Specialty
Pediatrics
Pediatrics - Adolescent MedicineAdolescent Medicine

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Organizations

Provider Name
University of Utah Pediatric Services

Part of University of Utah Pediatric Services

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