MEDICARE: MICHAEL BRIAN LLOYD 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
1	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	341238-1205	UT
2	208000000X	Pediatrics Physician	341238-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7645	OTHER	UT	UNIV OF UTAH HEALTH PLANS

General Provider Information

NPI Number	:	1497753354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BRIAN LLOYD M.D.

Provider Business Mailing Address
First Line	:	7200 REINDEER DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-4451
Country	:	US
Telephone Number	:	801-733-9594
Fax Number	:	801-927-1591

Provider Business Practice Location Address
First Line	:	100 N MEDICAL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84113-1103
Country	:	US
Telephone Number	:	801-587-7575
Fax Number	:	801-285-1704

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	11/18/2021

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