Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 12208314-1205 | UT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 12208314-1205 | UT |
NPI | 1306387667 |
---|---|
Provider Name | Matthew B. Givens |
First Address | Salt Lake City, UT 84132-2209 |
Second Address | Salt Lake City, UT 84132-2209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2017 |
Last Update Date | 01/11/2021 |