Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 761601451205 | UT |
NPI | 1063525996 |
---|---|
Provider Name | Paul A Miner |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Murray, UT 84107-8100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 22/10/2007 |