Tietze, Christopher C.

Tietze, Christopher C. is an individual health care provider with primary practice located at 50 N Medical Dr , Salt Lake City UT 84132-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Tietze, Christopher C. can be contacted via phone (801) 581-7802.

Contact Information

Primary practice address
50 N Medical Dr Salt Lake City UT 84132-0001
Phone: (801) 581-7802
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 183411-1205 Utah
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 183411-1205 Utah

Profile Details

NPI number 1811087448
LBN Legal business name Tietze, Christopher C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jan 18th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811087448 NPPES
Idaho MEDICAID 003045300
Idaho MEDICAID 10234
Idaho Other 100002311

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