Evolve Medical

LBN: Physician Medical Group
Evolve Medical is an health care organization with primary practice located at 4624 S Holladay Blvd Ste 202 , Salt Lake City UT 84117-7168. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as the primary health care specialty. Physician Medical Group can be contacted via phone (385) 800-5015, or through Simbari, Jenny via phone (385) 800-5015.

Contact Information

Primary practice address
4624 S Holladay Blvd Ste 202 Salt Lake City UT 84117-7168
Phone: (385) 800-5015
Fax: (801) 277-6678
Website:
Map and Directions
Authorized official contact:
Name: Simbari, Jenny
Phone: (385) 800-5015

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X

Profile Details

NPI number 1972078723
LBN Legal business name Physician Medical Group
DBA Doing business as Evolve Medical
Authorized official Simbari, Jenny
Entity Organization
Organization subpart 1 No
Enumeration date Oct 8th, 2018
Last updated Feb 12th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972078723 NPPES
Utah Other 1740543834 INDIVIDUAL NPI
Utah Other 1619935053 INDIVIDUAL NPI
Utah Other 1184807208 INDIVIDUAL NPI
Utah Other 1356897821 INDIVIDUAL NPI
Utah Other 1861622219 INDIVIDUAL NPI
Utah Other 1972078723 INDIVIDUAL NPI

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