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NPI Code Detail

MEDICARE: ANDREW SPENCER FINNERAN DO

MEDICARE:   ANDREW SPENCER FINNERAN  DO
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
12084P0800XPsychiatry Physician2022-00744NC
2390200000XStudent in an Organized Health Care Education/Training Program260938NC
32084P0800XPsychiatry Physician13781591-1204UT

General Provider Information

NPI Number : 1669093860
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW SPENCER FINNERAN DO
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3903 MEDICAL DR STE 300
Second Line :
City : OGDEN
State : UT
Zip : 84403-2317
Country : US
Telephone Number : 801-387-5600
Fax Number : 801-387-4929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2020
Last Update Date : 06/18/2024

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Directions to “ ANDREW SPENCER FINNERAN DO” Practice Location

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