Brieske, Mary E

Brieske, Mary E is an individual health care provider with primary practice located at 360 E 4500 S Ste 4 , Salt Lake City UT 84107-4297. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Brieske, Mary E can be contacted via phone (801) 266-0055.

Contact Information

Primary practice address
360 E 4500 S Ste 4 Salt Lake City UT 84107-4297
Phone: (801) 266-0055
Fax: (801) 266-0056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 3842 Alaska

Profile Details

NPI number 1649267303
LBN Legal business name Brieske, Mary E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2005
Last updated Mar 3rd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649267303 NPPES
Alaska MEDICAID MD3842
Alaska MEDICAID 870326048001D7226

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