Healthcare Provider Details

I. General information

NPI: 1336380377
Provider Name (Legal Business Name): EMILY BROOKE ZURCHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2009
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 N 500 W UTAH VALLEY REGIONAL MEDICAL CENTER
PROVO UT
84604-3380
US

IV. Provider business mailing address

150 W CIVIC CENTER DR SUITE 200
SANDY UT
84070-4230
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7850
  • Fax: 801-432-2668
Mailing address:
  • Phone: 801-432-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number9127011-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: