Active NPI 1306209556 Individual Practitioner Male Practitioner

Dr. Garrett Coman , MD

Dermatology • Ketchum, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Garrett Coman, MD is a certified Dermatology practicing in Ketchum, ID. With approximately 11 years of clinical experience since graduating from University Of Utah School Of Medicine in 2015, Dr. Coman delivers high-quality medical care to the local community at ST. LUKE'S DERMATOLOGY.

Dr. Coman is affiliated with St Lukes Clinic - Wood River Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

St. Luke's Dermatology
191 5th Street West

Ketchum, ID 83340

Telephone 2087252171

Associated Practice Facility / Clinic

🏢 Steven L Karassik Md Pa Facility NPI 1386811826

Medicare Profile & Education

Medical School

University Of Utah School Of Medicine

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Ketchum, ID

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

11 Yrs -5.3 yrs vs City Avg

City Avg: 16.3 Yrs

State Avg: 23.0 Yrs

Regional Practice Density

4 Specialists

Practicing in Ketchum, ID (63 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Coman (11 Years) 11 Yrs

Ketchum Specialty Average (16.3 Years) 16.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,142	381	$5.22	$1.91
17003 Destruction of precancer skin growth, 2-14 growths	1,001	194	$5.26	$1.92
99213 Established patient office or other outpatient visit, typically 15 minutes	708	493	$147.31	$60.78
17000 Destruction of skin growth	633	482	$142.94	$37.79
17110 Destruction of up to 14 skin growths	429	334	$176.53	$60.47
11102 Tangential biopsy of single skin lesion	424	346	$104.25	$21.16
99213 Established patient office or other outpatient visit, typically 15 minutes	271	233	$147.80	$60.98
17000 Destruction of skin growth	260	225	$142.98	$38.68
11103 Biopsy of related skin growth, each additional growth	239	134	$59.51	$19.90
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	208	171	$217.55	$89.77
11102 Tangential biopsy of single skin lesion	173	158	$106.20	$21.86
17110 Destruction of up to 14 skin growths	162	144	$176.61	$62.78
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	113	86	$213.10	$77.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	110	97	$217.53	$89.70
11103 Biopsy of related skin growth, each additional growth	109	57	$59.50	$19.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	91	91	$183.00	$75.18
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	79	73	$79.00	$32.51
17004 Destruction of precancer skin growth, 15 or more growths	76	56	$257.91	$89.74
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	68	67	$494.12	$142.18
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	50	46	$532.16	$130.02
11900 Injection into skin growth, 1-7 growths	49	35	$82.22	$19.12
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	47	42	$443.23	$74.88
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	45	40	$534.07	$128.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$297.77	$122.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	35	35	$183.00	$75.13
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	35	33	$227.69	$90.73
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	32	$79.00	$32.44
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	32	29	$580.75	$170.98
11104 Punch biopsy, first skin growth	28	26	$128.25	$36.25
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	28	28	$232.86	$104.65
17004 Destruction of precancer skin growth, 15 or more growths	27	26	$263.78	$92.03
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	26	23	$262.46	$109.93
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	24	21	$166.83	$63.08
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	20	20	$509.25	$155.70
11900 Injection into skin growth, 1-7 growths	16	15	$82.06	$18.68
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	16	13	$235.25	$90.47
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	14	$203.29	$78.79
11104 Punch biopsy, first skin growth	14	14	$143.43	$36.54
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	13	$465.08	$77.03
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$295.33	$122.70
17111 Destruction of skin growth, 15 or more growths	12	11	$215.67	$76.22
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	11	11	$517.00	$172.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,905	364	$5.80	$1.96
17003 Destruction of precancer skin growth, 2-14 growths	784	143	$5.81	$2.00
99213 Established patient office or other outpatient visit, typically 15 minutes	664	487	$142.37	$62.30
17000 Destruction of skin growth	590	454	$135.86	$39.89
11102 Tangential biopsy of single skin lesion	430	344	$101.02	$21.83
17110 Destruction of up to 14 skin growths	355	278	$171.70	$58.96
11103 Biopsy of related skin growth, each additional growth	253	134	$58.29	$20.18
99213 Established patient office or other outpatient visit, typically 15 minutes	248	199	$142.35	$62.30
17000 Destruction of skin growth	217	188	$136.19	$39.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	182	157	$209.25	$92.13
11102 Tangential biopsy of single skin lesion	168	139	$101.05	$22.16
17110 Destruction of up to 14 skin growths	151	120	$172.44	$62.19
17004 Destruction of precancer skin growth, 15 or more growths	115	91	$251.95	$91.80
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	99	99	$186.11	$77.47
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	97	75	$212.73	$76.18
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	94	88	$488.81	$151.43
11103 Biopsy of related skin growth, each additional growth	93	51	$58.35	$20.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	72	$211.40	$92.46
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	69	65	$77.52	$33.46
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	68	58	$415.41	$74.85
17004 Destruction of precancer skin growth, 15 or more growths	50	43	$251.54	$91.79
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	43	35	$501.70	$135.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$186.72	$77.46
11900 Injection into skin growth, 1-7 growths	42	35	$79.64	$18.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$291.25	$125.34
11104 Punch biopsy, first skin growth	36	35	$126.61	$36.34
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	35	31	$228.49	$95.82
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	34	28	$264.21	$106.49
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	34	32	$522.85	$142.24
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	23	21	$234.09	$85.65
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	22	18	$549.64	$156.50
11900 Injection into skin growth, 1-7 growths	22	19	$79.82	$19.69
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	18	16	$202.72	$73.43
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	16	$77.47	$33.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$291.56	$125.36
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$438.75	$78.43
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$504.60	$157.11
11104 Punch biopsy, first skin growth	15	15	$126.53	$33.44
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	15	14	$235.60	$90.84
12035 Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs	13	12	$604.08	$186.70
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	12	12	$166.67	$57.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,766	318	$6.00	$1.99
99213 Established patient office or other outpatient visit, typically 15 minutes	573	423	$119.89	$63.01
17003 Destruction of precancer skin growth, 2-14 growths	568	120	$6.13	$2.02
17000 Destruction of skin growth	520	409	$134.00	$41.90
11102 Tangential biopsy of single skin lesion	405	326	$100.00	$23.30
11103 Biopsy of related skin growth, each additional growth	272	142	$58.00	$20.37
17110 Destruction of up to 14 skin growths	260	225	$171.00	$58.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	228	193	$180.41	$92.85
99213 Established patient office or other outpatient visit, typically 15 minutes	193	156	$121.28	$62.61
17000 Destruction of skin growth	172	147	$134.47	$42.64
11102 Tangential biopsy of single skin lesion	132	123	$102.17	$23.14
17004 Destruction of precancer skin growth, 15 or more growths	121	100	$250.00	$89.89
11103 Biopsy of related skin growth, each additional growth	112	53	$58.00	$20.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	100	100	$173.32	$77.96
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	96	92	$488.00	$144.66
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	92	68	$213.00	$73.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	74	$181.62	$91.89
17110 Destruction of up to 14 skin growths	78	69	$171.00	$60.32
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	70	62	$411.00	$75.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	70	64	$67.60	$33.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	64	64	$273.84	$126.79
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	51	47	$493.00	$130.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	47	47	$173.77	$77.05
11104 Punch biopsy, first skin growth	46	46	$126.00	$36.97
11900 Injection into skin growth, 1-7 growths	40	30	$79.00	$21.60
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	33	28	$167.00	$57.93
17004 Destruction of precancer skin growth, 15 or more growths	30	28	$254.17	$92.05
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	29	28	$521.00	$157.53
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	28	28	$504.00	$160.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$271.38	$126.81
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	20	$431.00	$77.71
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	19	$235.00	$95.42
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	18	13	$541.00	$149.60
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	12	$265.00	$107.12
11104 Punch biopsy, first skin growth	15	14	$126.00	$40.71
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	12	$203.00	$75.76
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	14	12	$229.00	$92.84
11900 Injection into skin growth, 1-7 growths	14	12	$79.00	$20.65
12035 Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs	13	13	$603.00	$185.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$71.17	$33.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,386	289	$6.01	$2.01
17003 Destruction of precancer skin growth, 2-14 growths	488	99	$6.16	$2.09
17000 Destruction of skin growth	425	350	$134.06	$41.27
99213 Established patient office or other outpatient visit, typically 15 minutes	404	310	$98.29	$63.64
11102 Tangential biopsy of single skin lesion	364	301	$100.79	$23.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	240	194	$150.33	$94.12
11103 Biopsy of related skin growth, each additional growth	234	138	$58.00	$20.57
17110 Destruction of up to 14 skin growths	220	184	$171.00	$57.05
99213 Established patient office or other outpatient visit, typically 15 minutes	168	146	$97.46	$63.77
17000 Destruction of skin growth	134	124	$134.81	$42.64
11102 Tangential biopsy of single skin lesion	124	118	$101.15	$25.59
17004 Destruction of precancer skin growth, 15 or more growths	96	78	$250.00	$90.70
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	94	94	$161.72	$78.51
11103 Biopsy of related skin growth, each additional growth	91	55	$58.00	$20.57
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	88	65	$213.00	$76.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	85	83	$48.94	$34.03
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	61	60	$488.00	$141.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	61	57	$150.90	$93.23
17110 Destruction of up to 14 skin growths	57	53	$171.00	$59.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$253.67	$128.03
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	48	45	$411.00	$76.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$159.25	$78.51
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	42	36	$493.00	$127.16
11900 Injection into skin growth, 1-7 growths	38	29	$79.00	$19.93
11104 Punch biopsy, first skin growth	35	31	$126.00	$36.74
88305 Pathology examination of tissue using a microscope, intermediate complexity	30	19	$114.63	$36.11
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	29	29	$521.00	$163.06
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	27	26	$50.81	$35.37
17004 Destruction of precancer skin growth, 15 or more growths	26	24	$250.00	$90.70
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	21	18	$237.00	$83.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$252.25	$128.03
11104 Punch biopsy, first skin growth	16	15	$126.00	$33.26
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	13	$235.00	$96.15
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	13	13	$541.00	$158.53
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	12	11	$229.00	$91.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	767	157	$6.02	$2.09
99213 Established patient office or other outpatient visit, typically 15 minutes	234	205	$96.35	$49.16
17000 Destruction of skin growth	196	187	$134.28	$48.19
11102 Tangential biopsy of single skin lesion	153	146	$100.93	$24.54
11103 Biopsy of related skin growth, each additional growth	102	59	$58.00	$21.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	54	54	$157.00	$72.37
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	33	30	$488.00	$163.16
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	31	$48.00	$24.58
99202 New patient office or other outpatient visit, typically 20 minutes	20	20	$107.70	$46.83
17004 Destruction of precancer skin growth, 15 or more growths	20	20	$250.00	$93.21
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	20	14	$213.00	$79.97
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	18	$421.68	$76.94
17110 Destruction of up to 14 skin growths	16	15	$171.00	$58.97
11104 Punch biopsy, first skin growth	16	16	$126.00	$42.48

Medical Specialties & State Licenses

CMS Verified: 2020-06-29

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License ID M-15211

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

St Lukes Clinic - Wood River Llc

100 Hospital Dr, Ketchum, ID 83340

St Lukes Clinic - Wood River Llc

191 5th St W, Ketchum, ID 833409998

Phone: 2087252171

St Lukes Clinic - Wood River Llc

21 E Maple St, Hailey, ID 833334900

Phone: 2087883200

St Lukes Clinic - Wood River Llc

100 Hospital Dr, Ketchum, ID 83340

Phone: 2086228811

St Lukes Clinic - Wood River Llc

100 Hospital Dr, Ketchum, ID 833409998

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Matthew Reeck , MD

Dermatology

NPI 1124022801

Doctor of Medicine (M.D.)

Dr. James Abbott , MD

Dermatology

NPI 1518490283

Doctor of Medicine (M.D.)

Dr. Steven Karassik , MD

Dermatology

NPI 1891748117

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location June 29, 2020

Registered at ST. LUKE'S DERMATOLOGY, 191 5TH STREET WEST, KETCHUM, ID 83340 (Tel: 2087252171)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2020

Dermatology (License #M-15211 in ID)

✅

NPI Profile Active April 04, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location April 04, 2016

Registered at UNIVERSITY HOSPITAL, 30 N 1900 E ROOM 4C104, SALT LAKE CITY, UT 84132 (Tel: 8015817606)

📍

Updated Business Mailing Address April 04, 2016

Registered at UNIVERSITY HOSPITAL, 30 N 1900 E ROOM 4C104, SALT LAKE CITY, UT 84132

👤

Provider Name / Credentials Updated April 04, 2016

Recorded as GARRETT COMAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 04, 2016

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration April 04, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306209556

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 04, 2016

Last Update: June 29, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

University Hospital, 30 N 1900 E Room 4c104

Salt Lake City, UT 84132

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.