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General NPI Number Information
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NPI Number | 1407840200
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Entity Type | Individual
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Provider Name | THOMAS S MEULEMAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 3838 S 700 E SUITE 200
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-1466
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Country | US
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Telephone | 801-267-4988
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Fax | 801-269-9427
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Provider Business Mailing Address
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Address Line | PO BOX 27688
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0688
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Country | US
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Telephone | 801-534-1360
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Fax | 801-366-9883
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 164017-1205
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License Number State | UT
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