MEDICARE: DR. STANLEY MARK HUFF 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
1	207ZC0006X	Clinical Pathology Physician	168488-1205	UT

General Provider Information

NPI Number	:	1952565442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY MARK HUFF MD

Provider Business Mailing Address
First Line	:	4646 LAKE PARK BLVD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84120-8212
Country	:	US
Telephone Number	:	801-442-4885
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 LAKE PARK BLVD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84120-8212
Country	:	US
Telephone Number	:	801-442-4885
Fax Number	:

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

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	07/14/2008

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