Healthcare Provider Details
I. General information
NPI: 1528231511
Provider Name (Legal Business Name): MARGARET E. M. VAN METER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2008
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5171 S COTTONWOOD ST STE 610
MURRAY UT
84107-5704
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 801-507-3630
- Fax: 801-507-3640
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 10304629-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: