Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 1620951205 | UT |
NPI | 1003874736 |
---|---|
Provider Name | Wynn H Hemmert |
First Address | Provo, UT 84604-3305 |
Second Address | American Fork, UT 84003-2912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 17/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0423 | DMBA (01) | UT |
107006220101 | IHC HEALTHPLANS (01) | UT |
1692 | PEHP (01) | UT |
29-00039 | UNITED HEALTHCARE (01) | UT |
870281028000 | (05) | UT |
870281028HE1 | EMIA (01) | UT |
C63926 | (02) | UT |
QM0000009173 | ALTIUS (01) | UT |