Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 8331671-1205 | UT |
NPI | 1033311071 |
---|---|
Provider Name | Mary Hunt Martin |
First Address | Salt Lake City, UT 84141-3021 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 20/11/2021 |