| Atlas Internal Medicine Llc | |
|
6965 S Union Park Ctr Ste 430 Cottonwood Heights UT 84047-6507 | |
| (385) 308-8937 | |
| (801) 701-8308 |
| Full Name | Atlas Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6965 S Union Park Ctr Ste 430, Cottonwood Heights, Utah |
| Authorized Official Name and Position | Kavita G Willesen (OWNER) |
| Authorized Official Contact | 8018453736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlas Internal Medicine Llc 8165 S Willow Creek Cv Cottonwood Heights UT 84093-6203 Ph: (801) 809-9471 | Atlas Internal Medicine Llc 6965 S Union Park Ctr Ste 430 Cottonwood Heights UT 84047-6507 Ph: (385) 308-8937 |
| NPI Number | 1467110833 |
|---|---|
| Provider Enumeration Date | 12/02/2021 |
| Last Update Date | 07/11/2022 |
| Medicare PECOS PAC ID | 6608267455 |
|---|---|
| Medicare Enrollment ID | O20220105001113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467110833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kavita Gangar Willesen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689684185 PECOS PAC ID: 2961482971 Enrollment ID: I20220107000849 |
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