Healthcare Provider Details

I. General information

NPI: 1770530800
Provider Name (Legal Business Name): GERALD SAUL TREIMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 FOOTHILL DRIVE
SALT LAKE CITY UT
84103
US

IV. Provider business mailing address

500 FOOTHILL DRIVE
SALT LAKE CITY UT
84103
US

V. Phone/Fax

Practice location:
  • Phone: 801-582-1565
  • Fax: 801-606-2795
Mailing address:
  • Phone: 801-582-1565
  • Fax: 801-606-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number3233851205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: