Healthcare Provider Details

I. General information

NPI: 1558407288
Provider Name (Legal Business Name): EVE MAHER-YOUNG P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 W 300 S
MOAB UT
84532-2543
US

IV. Provider business mailing address

450 WILLIAMS WAY
MOAB UT
84532-2185
US

V. Phone/Fax

Practice location:
  • Phone: 435-259-7121
  • Fax: 435-259-3112
Mailing address:
  • Phone: 435-719-3501
  • Fax: 435-719-3509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number325073-1206
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: