Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEREMY WALLENTINE, M.D.
Active Sole ProprietorJEREMY WALLENTINE, M.D. is a Anatomic Pathology & Clinical Pathology healthcare provider located in SLC, Utah. NPI 1619130036 is currently active in the NPPES registry. Verify at CMS.
Anatomic Pathology & Clinical Pathology · SLC, UT
Registration Details
- NPI Number
- 1619130036
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 7, 2008 (18.136871065422 yrs)
- Last Updated
- Nov 9, 2011
- License
-
3289491205 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2913 GARDEN MEADOWS CVSLC, UT, 841061302Browse UT providers · Browse ZIP 84106
- Phone
- 8018652442
- Primary Specialty
-
Anatomic Pathology & Clinical Pathology
207ZP0102X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.