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General NPI Number Information
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NPI Number | 1659725851
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Entity Type | Individual
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Provider Name | CHRISTOPHER DUANE NEVALA-PLAGEMANN
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Gender | Male
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 30 N 1900 E # SOM DEPARTMENT OF MEDICINE - ROOM 4C116
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0002
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Country | US
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Telephone | 801-581-7899
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Fax | 801-585-0418
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Provider Business Mailing Address
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Address Line | 30 N 1900 E # SOM DEPARTMENT OF MEDICINE - ROOM 4C116
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0002
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Country | US
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Telephone | 801-581-7899
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Fax | 801-585-0418
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 10514857-1205
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License Number State | UT
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