Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 182204-1205 | UT |
N | 207ND0900X | Dermatopathologist | 182204-8905 | UT |
Y | 207NS0135X | Procedural Dermatology | 182204-8905 | UT |
NPI | 1174520597 |
---|---|
Provider Name | Dr. Steven Paul Eyre |
First Address | Orem, UT 84057-3728 |
Second Address | Orem, UT 84057-3728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 25/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E70079 | (02) | UT |