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General NPI Number Information
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NPI Number | 1265990329
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Entity Type | Organization
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Legal Business Name | STEPS MD
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 901 S OREM BLVD
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City | OREM
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State | UT
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Zip | 84058-5011
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Country | US
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Telephone | 801-465-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 996 W 800 S
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City | PAYSON
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State | UT
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Zip | 84651-2766
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Country | US
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Telephone | 801-465-5111
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JEREMIAH GOLESH
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Credential |
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Telephone | 801-455-2687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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