| Ivan D Flint MD PC | |
|
1250 E 3900 S Ste 450 Slc UT 84124-1349 | |
| (801) 262-3600 | |
| (801) 206-2555 |
| Full Name | Ivan D Flint MD PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1250 E 3900 S Ste 450, Slc, Utah |
| Authorized Official Name and Position | Ivan D Flint (MD/ PRESIDENT) |
| Authorized Official Contact | 8012623600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan D Flint MD PC 1250 E 3900 S Ste 450 Slc UT 84124-1349 Ph: (801) 262-3600 | Ivan D Flint MD PC 1250 E 3900 S Ste 450 Slc UT 84124-1349 Ph: (801) 262-3600 |
| NPI Number | 1821271529 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 12/17/2007 |
| Medicare PECOS PAC ID | 9830128222 |
|---|---|
| Medicare Enrollment ID | O20050805000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821271529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3200011205 (Utah) | Primary |
| Provider Name | Ivan D Flint |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1962484485 PECOS PAC ID: 0941239743 Enrollment ID: I20060116000215 |
| Provider Name | Christopher a Neville |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689617714 PECOS PAC ID: 8921012626 Enrollment ID: I20060202000120 |
| Provider Name | Mark P Pulver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205007093 PECOS PAC ID: 6709964745 Enrollment ID: I20080416000497 |
| Provider Name | Audrey Dean |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1053765784 PECOS PAC ID: 5799070074 Enrollment ID: I20240813004113 |
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