MEDICARE: ROBERT B TOPHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	2770041205	UT

General Provider Information

NPI Number	:	1144290479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT B TOPHAM MD

Provider Business Mailing Address
First Line	:	1775 E 4500 S
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-4203
Country	:	US
Telephone Number	:	801-272-4408
Fax Number	:	801-272-4441

Provider Business Practice Location Address
First Line	:	1775 E 4500 S
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-4203
Country	:	US
Telephone Number	:	801-272-4408
Fax Number	:	801-272-4441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	02/14/2024

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