Healthcare Provider Details

I. General information

NPI: 1841240330
Provider Name (Legal Business Name): DON L STROMQUIST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 MYRTLE AVE SUITE 204
MURRAY UT
84107-4833
US

IV. Provider business mailing address

154 MYRTLE AVE SUITE 204
MURRAY UT
84107-4833
US

V. Phone/Fax

Practice location:
  • Phone: 801-266-9300
  • Fax: 801-266-9305
Mailing address:
  • Phone: 801-266-9300
  • Fax: 801-266-9305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number18487-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: