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General NPI Number Information
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NPI Number | 1124296827
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Entity Type | Organization
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Legal Business Name | PAUL PILGRAM M.D. P.C.
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 1561 W 7000 S SUITE 200
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City | WEST JORDAN
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State | UT
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Zip | 84084-3556
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Country | US
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Telephone | 801-562-5300
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Fax | 801-562-1883
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Provider Business Mailing Address
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Address Line | 8555 TOP OF THE WORLD CIR
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-6083
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Country | US
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Telephone | 801-562-5300
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Fax | 801-562-1883
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL E. PILGRAM
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Credential | M.D.
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Telephone | 801-562-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 167518-1205
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License Number State | UT
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