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NPI Code Detail

MEDICARE: DR. PAUL E WIRKUS MD

MEDICARE: DR. PAUL E WIRKUS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician183385-1205UT

General Provider Information

NPI Number : 1134101835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL E WIRKUS MD
Provider Business Mailing Address
First Line : 5770 S 250 E
Second Line : SUITE 290
City : MURRAY
State : UT
Zip : 84107-8100
Country : US
Telephone Number : 801-747-8700
Fax Number : 801-747-8701
Provider Business Practice Location Address
First Line : 5770 S 250 E
Second Line : SUITE 290
City : MURRAY
State : UT
Zip : 84107-8100
Country : US
Telephone Number : 801-747-8700
Fax Number : 801-747-8701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 05/26/2010

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Directions to “ DR. PAUL E WIRKUS MD” Practice Location

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