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NPI Code Detail

MEDICARE: DR. MARLA WEISSLER DUDAK M.D.

MEDICARE: DR. MARLA WEISSLER DUDAK M.D.
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
1208600000XSurgery PhysicianME72788FL
22086X0206XSurgical Oncology PhysicianME72788FL
32086X0206XSurgical Oncology Physician13143314-1205UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P01601033OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17507281OTHERFLAETNA
2P975925OTHERFLOPTIMUM
41035777OTHERFLCAREPLUS
53080244OTHERFLCIGNA
6330975OTHERFLWELLCARE
7280120OTHERFLAVMED
8P1041371OTHERFLFREEDOM
905071OTHERFLBCBS
10MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154359529
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARLA WEISSLER DUDAK M.D.
Provider Business Mailing Address
First Line : 3702 ASPEN PT
Second Line :
City : PARK CITY
State : UT
Zip : 84098-4912
Country : US
Telephone Number : 561-706-0234
Fax Number :
Provider Business Practice Location Address
First Line : 1220 E 3900 S STE 4I
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1383
Country : US
Telephone Number : 801-948-2380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 03/05/2024

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