Dr Venugopal Amula, | |
100 N Mario Capecchi Dr, Slc, UT 84113-1103 | |
(806) 622-2550 | |
Not Available |
Full Name | Dr Venugopal Amula |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Critical Care Medicine |
Location | 100 N Mario Capecchi Dr, Slc, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528268448 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 4301089982 (Michigan) | Secondary |
2080P0203X | Pediatrics - Pediatric Critical Care Medicine | 7391530-1205 (Utah) | Primary |
Entity Name | University Of Utah Pediatric Acuity Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619325131 PECOS PAC ID: 6406148345 Enrollment ID: O20160713000869 |
Mailing Address | Practice Location Address |
---|---|
Dr Venugopal Amula, 100 N Mario Capecchi Dr, Slc, UT 84113-1103 Ph: (801) 662-2550 | Dr Venugopal Amula, 100 N Mario Capecchi Dr, Slc, UT 84113-1103 Ph: (806) 622-2550 |
Molly A O'gorman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 N Medical Dr, Slc, UT 84113 Phone: 801-588-2000 | |
Dr. Jared W Henricksen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Mario Capecchi Dr, Slc, UT 84113 Phone: 801-662-1000 | |
Dr. Louis Borgenicht, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 850 E 300 S Ste 5, Slc, UT 84102 Phone: 801-531-8689 Fax: 801-531-1277 | |
James Thomas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 295 S Chipeta Way, Slc, UT 84108 Phone: 801-581-4178 Fax: 801-587-7417 | |
Spencer Barfuss, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 81 N Mario Capecchi Dr, Slc, UT 84113 Phone: 801-213-7609 |