Bahoravitch, Dirk Bradley

Bahoravitch, Dirk Bradley is an sole proprietor health care provider with primary practice located at 1067 N 500 W , Provo UT 84604-3305. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Bahoravitch, Dirk Bradley can be contacted via phone (801) 374-0354.

Contact Information

Primary practice address
1067 N 500 W Provo UT 84604-3305
Phone: (801) 374-0354
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 53485 Idaho

Profile Details

NPI number 1184083826
LBN Legal business name Bahoravitch, Dirk Bradley
Credentials MSN, CRNA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2016
Last updated Jan 19th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers