Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 9529362-1205 | UT |
N | 111NI0900X | Internist | 9529362-1205 | UT |
Y | 207RI0200X | Infectious Disease | 9529362-1205 | UT |
NPI | 1073932851 |
---|---|
Provider Name | Dr. Steven Kyle Throneberry |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84132-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 23/01/2020 |