Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 4991679-1205 | UT |
NPI | 1083740070 |
---|---|
Provider Name | Dr. Julie D Asch |
First Address | Park City, UT 84098-5310 |
Second Address | Salt Lake City, UT 84143-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 10/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107009706106 | SELECT HEALTH (01) | UT |
302934 | ALTIUS (01) | UT |
4991679-1205 | STATE LICENSE (01) | UT |
93795 | PEHP UCS (01) | UT |
BA2589654 | DEA (01) | |
D4198 | (05) | UT |
G06502 | (02) | UT |