Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 6668569-8905 | UT |
Y | 207RC0200X | Critical Care Medicine | 6668569-1205 | UT |
NPI | 1154515765 |
---|---|
Provider Name | Dr. Timothy J Gayowski |
First Address | Salt Lake City, UT 84132-0001 |
Second Address | Salt Lake City, UT 84102-1907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 07/12/2015 |