| Mountain Top Medical, Pllc | |
|
140 E 1000 S Ste B2 Brigham City UT 84302-4399 | |
| (435) 515-3030 | |
| (435) 515-3434 |
| Full Name | Mountain Top Medical, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 140 E 1000 S Ste B2, Brigham City, Utah |
| Authorized Official Name and Position | Michael C Shaw (CO-OWNER) |
| Authorized Official Contact | 4355153030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Top Medical, Pllc 140 E 1000 S Ste B2 Brigham City UT 84302-4399 Ph: (435) 515-3030 | Mountain Top Medical, Pllc 140 E 1000 S Ste B2 Brigham City UT 84302-4399 Ph: (435) 515-3030 |
| NPI Number | 1235783994 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 07/30/2019 |
| Medicare PECOS PAC ID | 1355672288 |
|---|---|
| Medicare Enrollment ID | O20191008001703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235783994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael C Shaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235161936 PECOS PAC ID: 4789585118 Enrollment ID: I20040117000213 |
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