Doctor Name: | DR. KEITH L. BLAUER |
NPI Number: | 1962475350 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 567553-1205 & 8905 |
Business Practice Address: | 10150 Petunia Way Sandy, UT - 840924380 |
Business Phone Number: | 8018788888 |
Business Fax Number: | 8018788890 |
Mailing Address: | 10150 Petunia Way, SANDY |
State: | UT |
Postal Code: | 840924380 |
Phone Number: | 8018788888 |
Fax Number: | 8018788890 |
NPI Enumeration Date: | 02/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 567553-1205 & 8905 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |