Mineau, D Edward
Mineau, D Edward is an individual health care provider with primary practice located at 1200 E 3900 S , Salt Lake City UT 84124-1300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mineau, D Edward can be contacted via phone (801) 268-7111.Contact Information
Primary practice address
1200 E 3900 S
Salt Lake City UT 84124-1300
Phone: (801) 268-7111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 152665-1205 | Utah |
Profile Details
| NPI number | 1669472320 |
|---|---|
| LBN Legal business name | Mineau, D Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2005 |
| Last updated | Feb 12th, 2009 - about 15 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 | 1669472320 | NPPES |
| Idaho | MEDICAID | 003812200 | |
| Idaho | MEDICAID | 120732600 | |
| Idaho | MEDICAID | 927741 | |
| Idaho | MEDICAID | 002087689 | |
| Idaho | MEDICAID | 04348 | |
| Idaho | Other | P00651547 |
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