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NPI Code Detail

MEDICARE: RITA FLORIAN PINGREE M.D.

MEDICARE:   RITA FLORIAN PINGREE  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
1390200000XStudent in an Organized Health Care Education/Training Program
2208D00000XGeneral Practice Physician10514919UT

General Provider Information

NPI Number : 1639430960
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA FLORIAN PINGREE M.D.
Provider Business Mailing Address
First Line : 350 S 200 E
Second Line : 400
City : SALT LAKE CITY
State : UT
Zip : 84111-2410
Country : US
Telephone Number : 801-558-6563
Fax Number :
Provider Business Practice Location Address
First Line : 350 S 200 E
Second Line : 400
City : SALT LAKE CITY
State : UT
Zip : 84111-2410
Country : US
Telephone Number : 801-558-6563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2012
Last Update Date : 10/21/2019

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Directions to “ RITA FLORIAN PINGREE M.D.” Practice Location

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