MEDICARE: ID CONSULTS PLLC

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	207RI0200X	Infectious Disease Physician

General Provider Information

NPI Number	:	1184944803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ID CONSULTS PLLC

Provider Business Mailing Address
First Line	:	7929 FOREST OAKS CT
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-5737
Country	:	US
Telephone Number	:	801-274-0317
Fax Number	:

Provider Business Practice Location Address
First Line	:	6360 S 3000 E
Second Line	:	STE 230
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-6923
Country	:	US
Telephone Number	:	801-748-1173
Fax Number	:	801-748-1163

Authorized Official
Title or Position	:	MANAGER
Name	:	STEPHANIE GELMAN
Credential	:	M.D.
Telephone Number	:	801-274-0317

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	12/02/2015

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Directions to “ID CONSULTS PLLC ” Practice Location

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