| Gavin Van Staden Md Pc | |
|
3263 S Highway 89 Ste 300 Bountiful UT 84010-8555 | |
| (801) 296-0600 | |
| Not Available |
| Full Name | Gavin Van Staden Md Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 3263 S Highway 89, Bountiful, Utah |
| Authorized Official Name and Position | Gavin Van Staden (DR) |
| Authorized Official Contact | 8012012771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gavin Van Staden Md Pc 3263 S Highway 89 Ste 300 Bountiful UT 84010-8555 Ph: () - | Gavin Van Staden Md Pc 3263 S Highway 89 Ste 300 Bountiful UT 84010-8555 Ph: (801) 296-0600 |
| NPI Number | 1801174172 |
|---|---|
| Provider Enumeration Date | 08/03/2011 |
| Last Update Date | 08/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801174172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5863514-1205 (Utah) | Primary |
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