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General NPI Number Information
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NPI Number | 1447351978
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Entity Type | Individual
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Provider Name | GIOSUE PETER FEOLA MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 100 N MEDICAL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84113-1103
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Country | US
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Telephone | 801-662-1900
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Fax | 801-662-1810
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Provider Business Mailing Address
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Address Line | 869 E 4500 S PMB 511
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-3049
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Country | US
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Telephone | 801-487-0451
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Fax | 801-487-2467
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | DR.0075917
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | DR.0075917
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 347711-1205
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | DR.0075917
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DR.0075917
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License Number State | CO
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