Healthcare Provider Details

I. General information

NPI: 1285631358
Provider Name (Legal Business Name): MARILYN LOUISE CURRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S 200 E STE B
SALT LAKE CITY UT
84111-3802
US

IV. Provider business mailing address

461 S 400 E
SLC UT
84111-3302
US

V. Phone/Fax

Practice location:
  • Phone: 801-539-8617
  • Fax: 801-746-0420
Mailing address:
  • Phone: 801-566-5494
  • Fax: 801-537-7238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number173612-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: