Healthcare Provider Details
I. General information
NPI: 1225051527
Provider Name (Legal Business Name): HOWARD L GARBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/26/2006
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 N MAIN ST
RICHFIELD UT
84701-2061
US
IV. Provider business mailing address
PO BOX 30180
SALT LAKE CITY UT
84130-0180
US
V. Phone/Fax
- Phone: 435-893-4100
- Fax:
- Phone: 801-450-3770
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | 167248-1205 |
| License Number State | UT |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 103727 |
| Identifier Type | MEDICAID |
| Identifier State | AZ |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: