Edson, D Michael
Edson, D Michael is an sole proprietor health care provider with primary practice located at 3460 Pioneer Pkwy , West Valley City UT 84120-2049. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Edson, D Michael can be contacted via phone (801) 964-3100.Contact Information
Primary practice address
3460 Pioneer Pkwy
West Valley City UT 84120-2049
Phone: (801) 964-3100
Fax: (801) 296-1715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 149562-1205 | Utah |
Profile Details
| NPI number | 1811995814 |
|---|---|
| LBN Legal business name | Edson, D Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Jan 21st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811995814 | NPPES |
| Utah | MEDICAID | 03911 |
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