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NPI Code Detail

MEDICARE: CRAIG BREWSTER HUMMEL MD

MEDICARE: CRAIG BREWSTER HUMMEL 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 Physician200401403NC

General Provider Information

NPI Number : 1427099662
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG BREWSTER HUMMEL MD
Provider Business Mailing Address
First Line : 435 W BEARCAT DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-2519
Country : US
Telephone Number : 801-633-4484
Fax Number :
Provider Business Practice Location Address
First Line : 435 W BEARCAT DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-2519
Country : US
Telephone Number : 801-633-4484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 07/28/2020

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