Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 5134 | AL |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6632857 | UT |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DE00010382 | WA |
NPI | 1063492981 |
---|---|
Provider Name | Dr. Tate Lott Viehweg |
First Address | Lehi, UT 84043-5563 |
Second Address | Lehi, UT 84043-5563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 23/10/2020 |