Healthcare Provider Details

I. General information

NPI: 1265618656
Provider Name (Legal Business Name): ARTHRITIS & INTERNAL MEDICINE ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 E 3900 S SUITE B-275
SALT LAKE CITY UT
84124-1216
US

IV. Provider business mailing address

1151 E 3900 S SUITE B-275
SALT LAKE CITY UT
84124-1216
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-2452
  • Fax: 801-262-1028
Mailing address:
  • Phone: 801-262-2452
  • Fax: 801-262-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number5229
License Number StateUT

VIII. Authorized Official

Name: DR. STEVEN JAY ANDERSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 801-262-2452