| Direct MD Utah II LLC | |
|
7070 S Union Park Ave Ste 300 Midvale UT 84047-6061 | |
| (801) 421-0200 | |
| Not Available |
| Full Name | Direct MD Utah II LLC |
|---|---|
| Speciality | General Practice |
| Location | 7070 S Union Park Ave Ste 300, Midvale, Utah |
| Authorized Official Name and Position | Travis Winward (PRESIDENT) |
| Authorized Official Contact | 2087409076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Direct MD Utah II LLC 7070 S Union Park Ave Ste 300 Midvale UT 84047-6061 | Direct MD Utah II LLC 7070 S Union Park Ave Ste 300 Midvale UT 84047-6061 Ph: (801) 421-0200 |
| NPI Number | 1629939285 |
|---|---|
| Provider Enumeration Date | 11/21/2025 |
| Last Update Date | 11/21/2025 |
| Certification Date | 11/21/2025 |
| Medicare PECOS PAC ID | 5395217624 |
|---|---|
| Medicare Enrollment ID | O20260617002362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629939285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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