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NPI Code Detail

MEDICARE: MARIANNE EMMANUELLE DUBARD-GAULT M.D.

MEDICARE:   MARIANNE EMMANUELLE DUBARD-GAULT  M.D.
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
1207R00000XInternal Medicine PhysicianMD60974578WA
2207SG0201XClinical Genetics (M.D.) PhysicianMD60974578WA

Other Identifiers

General Provider Information

NPI Number : 1447678206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE EMMANUELLE DUBARD-GAULT M.D.
Provider Business Mailing Address
First Line : PO BOX 25608
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84125-0608
Country : US
Telephone Number : 206-320-4476
Fax Number : 206-568-7043
Provider Business Practice Location Address
First Line : 1221 MADISON ST STE 500
Second Line :
City : SEATTLE
State : WA
Zip : 98104-1388
Country : US
Telephone Number : 206-386-2552
Fax Number : 206-215-3959
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2014
Last Update Date : 11/02/2024

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Directions to “ MARIANNE EMMANUELLE DUBARD-GAULT M.D.” Practice Location

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