Healthcare Provider Details

I. General information

NPI: 1497332092
Provider Name (Legal Business Name): MICHAEL BESSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 04/09/2024
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HELIX: 30 N MARIO CAPECCHI DR RM 3N100
SALT LAKE CITY UT
84112
US

IV. Provider business mailing address

HELIX: 30 N MARIO CAPECCHI DR RM 3N100
SALT LAKE CITY UT
84112
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2121
  • Fax:
Mailing address:
  • Phone: 801-581-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number298095
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number13872433-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: