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General NPI Number Information
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NPI Number | 1245297688
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Entity Type | Individual
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Provider Name | MARK E MORITZ DPM
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1220 E 3900 S STE 4D
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-1383
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Country | US
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Telephone | 801-269-9939
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Fax | 801-269-9949
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Provider Business Mailing Address
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Address Line | PO BOX 404
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City | RIVERTON
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State | UT
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Zip | 84065-0404
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Country | US
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Telephone | 801-269-9939
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Fax | 801-405-7695
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 326708-8907
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 326708-0501
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License Number State | UT
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