MEDICARE: INTEGRATIVE MEDICAL ASSOCIATES

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
1	207Q00000X	Family Medicine Physician	1659453694	UT

General Provider Information

NPI Number	:	1144453739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	3650 N UNIVERSITY AVE STE 200
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6658
Country	:	US
Telephone Number	:	801-375-7100
Fax Number	:	801-375-7102

Provider Business Practice Location Address
First Line	:	3650 N UNIVERSITY AVE
Second Line	:	SUITE 200
City	:	PROVO
State	:	UT
Zip	:	84604-6656
Country	:	US
Telephone Number	:	801-375-7100
Fax Number	:	801-375-7102

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STUART B. PORTER
Credential	:	DO
Telephone Number	:	801-375-7100

Provider Enumeration Date	:	08/28/2009
Last Update Date	:	03/31/2026

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Practice Location Address:

3650 N UNIVERSITY AVE , SUITE 200
PROVO, UT
84604-6656

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1942210406 — CHARLES HERBERT STEWART M.D.
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Practice Location Address:

3650 N UNIVERSITY AVE , SUITE 200
PROVO, UT
84604-6656

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1982157301 — MS. REBEKAH MICHELLE HOSMAN PA-C
Practice Location Address:

3650 N UNIVERSITY AVE , #200
PROVO, UT
84604-6656

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Practice Location Address:

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1447861745 — MARLENE RIGGS
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