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NPI Code Detail

MEDICARE: CARISSA S MONROY MD

MEDICARE: CARISSA S MONROY 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
1207Q00000XFamily Medicine Physician74191611205UT

General Provider Information

NPI Number : 1760610349
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARISSA S MONROY MD
Provider Business Mailing Address
First Line : 660 S 200 E STE 250
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3846
Country : US
Telephone Number : 801-359-2256
Fax Number :
Provider Business Practice Location Address
First Line : 660 S 200 E STE 250
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3846
Country : US
Telephone Number : 801-359-2256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2009
Last Update Date : 12/19/2024

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Directions to “ CARISSA S MONROY MD” Practice Location

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