Healthcare Provider Details

I. General information

NPI: 1033022389
Provider Name (Legal Business Name): DR. IRASEMA PAUL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 E HORSE CREEK DR
MIDVALE UT
84047-2881
US

IV. Provider business mailing address

380 E HORSE CREEK DR
MIDVALE UT
84047-2881
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8299342-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: