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NPI Code Detail

MEDICARE: GREGORY RADIN M.D.

MEDICARE:   GREGORY  RADIN  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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician10308902-1205UT
2207R00000XInternal Medicine Physician10308902-1205UT
3207RP1001XPulmonary Disease Physician10308902-1205UT

General Provider Information

NPI Number : 1275823387
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY RADIN M.D.
Provider Business Mailing Address
First Line : 50 N MEDICAL DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84132-0001
Country : US
Telephone Number : 801-581-2353
Fax Number :
Provider Business Practice Location Address
First Line : 50 N MEDICAL DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84132-2526
Country : US
Telephone Number : 801-581-2353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2011
Last Update Date : 11/12/2021

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