NPI 1720079528 · live from the CMS NPI Registry
Christopher Funk, DPM
Podiatrist, Foot & Ankle Surgery in Salt Lake City, UT. National Provider Identifier 1720079528, active.
NPI record
| NPI | 1720079528 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 3130 S Highland Dr Ste B4, Salt Lake City, UT 84106 |
| Practice phone | 801-253-6886 |
| Mailing address | 280 S Main St, Bountiful, UT 84010 |
| Enumerated | October 31, 2005 |
| Last updated | July 23, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 0542 (AZ) |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | p-289 (ID) |
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 374325-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.