Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Pediatric Adolescent Medicine Department of Univeristy of Utah

Organization Pediatrics Physician · NPI 1639123896

Pediatric Adolescent Medicine Department of Univeristy of Utah provides Pediatrics Physician services in Salt Lake City, Utah. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

50 N Medical Dr
Salt Lake City, UT 84132-0001 Not confirmed with CMS for 15 years — call before visiting
Phone: (801) 581-3501
Fax: (801) 581-4920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1639123896
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edward Clark — Chair · (801) 587-7400
NPI enumeratedMay 20, 2006
Last updated in NPPESSeptember 6, 2011
Mailing address295 Chipeta Way, Peds Admin, Salt Lake City, UT 84108-1220

Other providers in Salt Lake City