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General NPI Number Information
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NPI Number | 1093622508
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Entity Type | Organization
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Legal Business Name | ELISABETH FERLIC MD, PLLC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 1474 E BRYAN AVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84105-2650
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Country | US
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Telephone | 435-344-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 1474 E BRYAN AVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84105-2650
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Country | US
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Telephone | 435-344-4760
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Fax |
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Authorized Official
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Title or Position | DOCTOR / OWNER
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Name | DR. ELISABETH ANNE FERLIC
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Credential | MD
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Telephone | 402-305-2380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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