Warren R Stack MD

NPI 1013088814 - Internal Medicine - 207R00000X

NPI Details
NPI 1013088814
Gender Male
Enumeration Date 11/13/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3540 S 4000 W
350
WEST VALLEY CITY UT, 84120, US
Phone (801) 968-8692
Fax (801) 968-9632
Business Location
3540 S 4000 W
350
WEST VALLEY CITY UT, 84120, US
Phone (801) 968-8692
Fax (801) 968-9632
Toxanomy
Taxonomy Code 207R00000X
License State Utah
License Number 1679021205
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According to our database, Dr. Warren R Stack MD NPI is 1013088814, taxonomy code is 207R00000X and license number is 1679021205, license state is located at Utah. Warren R Stack MD physically located at 3540 S 4000 W, West Valley City UT, 84120. NPI Number Warren R Stack MD has the Individual type.

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1013088814 NPI number is provided on an as is basis without warranty of any kind. 1013088814 is maintained by the National Plan & Provider Enumeration System. The contents of Warren R Stack MD are for informational purposes only.