Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 4752843-9924 | UT |
NPI | 1003826751 |
---|---|
Provider Name | Adam Rhees Bateman |
First Address | Lehi, UT 84043-5686 |
Second Address | Lehi, UT 84043-5686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 21/07/2016 |