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MOUNTAINSTAR CARDIOVASCULAR SERVICES LLC NPI 1093996167


NPI Information

NPI: 1093996167
Provider Name: MOUNTAINSTAR CARDIOVASCULAR SERVICES LLC
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization

CLIA Number: 46D2051013

Address:
698 W 800 N
SUITE #210
OREM, UT
ZIP 84057
Phone: (801) 714-6412
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MOUNTAINSTAR CARDIOVASCULAR SERVICES LLC is a thoracic surgery cardiothoracic vascular surgery in Orem, UT. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. MOUNTAINSTAR CARDIOVASCULAR SERVICES LLC NPI is 1093996167. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

698 W 800 N
SUITE #210
OREM, UT
ZIP 84057-658
Phone: (801) 714-6412
Fax: (801) 714-6413

The provider's authorized official is Kirt L. Peterson .
The authorized official title is Administrator and has the following contact phone number (801) 743-4750.

The CLIA number assigned to this NPI record is 46D2051013 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2007 and was last updated on 11/16/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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