NPI 1003286758

Willard Dere, MD

Practitioner Internal Medicine Physician Salt Lake City, UT

Practice location

Address: 500 Foothill Blvd, Salt Lake City, UT 84148-0001
Phone: (801) 582-1565
Mailing address: 15 N 2030 E Room 2160a, Salt Lake City, UT 84112-5339

Registered specialties

Internal Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207R00000X Licence 01038107A (IN)

Other Internal Medicine providers in Utah →

Registry record

NPI: 1003286758
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Oct 2015
Record last updated: 6 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.