PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH NPI 1609820232

NPI Information

  • NPI: 1609820232
  • Provider Name: PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH
  • Classification: Pediatrics - 2080P0206X
  • Specialization: Pediatric Gastroenterology
  • Entity Type: Organization
  • Address: 100 N MEDICAL DR
    SALT LAKE CITY, UT
    ZIP 84113
  • Phone: (801) 588-3370

Map and Directions

Get Directions

NPI Details

PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH is a pediatric gastroenterology pediatrics in Salt Lake City, UT. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH NPI is 1609820232. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84113-103
Phone: (801) 588-3370
Fax: (801) 588-2375

The provider's authorized official is Edward B Clark .
The authorized official title is Chair and has the following contact phone number (801) 587-7400.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 9/6/2011.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsNo
22080P0206XPediatricsPediatric GastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000057979MEDICARE ID-TYPE UNSPECIFIEDUTAH
2=========001MEDICAIDUTAH
3807149700MEDICAIDIDAHO
4121245100MEDICAIDWYOMING
5100507106MEDICAIDNEVADA

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.