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NPI Code Detail

MEDICARE: AFERDIT SADRIJA

MEDICARE: AFERDIT SADRIJA
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
1363A00000XPhysician Assistant13005355-1206UT
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1518371772
Entity Type Code : Individual
Provider Name (Legal Business Name) : AFERDIT SADRIJA
Provider Business Mailing Address
First Line : 375 S CHIPETA WAY STE A200
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1261
Country : US
Telephone Number : 801-581-6617
Fax Number :
Provider Business Practice Location Address
First Line : 375 S CHIPETA WAY STE A200
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1261
Country : US
Telephone Number : 801-581-6617
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2014
Last Update Date : 03/04/2024

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Directions to “ AFERDIT SADRIJA ” Practice Location

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