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NPI Code Detail

MEDICARE: MICHAELA SIEMES MOHR MD

MEDICARE: MICHAELA SIEMES MOHR 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
12084P0800XPsychiatry Physician166175-1205UT

General Provider Information

NPI Number : 1326038985
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELA SIEMES MOHR MD
Provider Business Mailing Address
First Line : 1514 EMERSON AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2728
Country : US
Telephone Number : 801-466-1822
Fax Number : 801-484-1812
Provider Business Practice Location Address
First Line : 1514 EMERSON AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2728
Country : US
Telephone Number : 801-466-1822
Fax Number : 801-484-1812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 07/08/2007

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