NPI 1063851871 · live from the CMS NPI Registry
Bryce Desmond, D.O.
Dermatology in Sandy, UT. National Provider Identifier 1063851871, active.
NPI record
| NPI | 1063851871 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 9450 S 1300 E, Sandy, UT 84094 |
| Practice phone | 801-501-6333 |
| Mailing address | Po Box 27128, Salt Lake City, UT 84127 |
| Enumerated | June 14, 2013 |
| Last updated | July 21, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | PG163800 (OR) |
| Dermatology primary | 207N00000X | 10232794-1204 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.