Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 12229851-1205 | UT |
N | 207X00000X | Orthopaedic Surgeon | 4301108208 | MI |
N | 207X00000X | Orthopaedic Surgeon | A168474 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A168474 | CA |
NPI | 1285016220 |
---|---|
Provider Name | Dr. Monte V. A. Squiers |
First Address | Salt Lake City, UT 84108-1200 |
Second Address | Salt Lake City, UT 84108-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2015 |
Last Update Date | 19/11/2021 |