Provider Demographics
NPI:1073607313
Name:BLOOD, TODD S (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:S
Last Name:BLOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:9660 SOUTH 1300 EAST
Practice Address - Street 2:ALTA VIEW HOSPITAL
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094
Practice Address - Country:US
Practice Address - Phone:801-501-2600
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT311840-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT2090168OtherUNITED HEALTHCARE
UT73605OtherPEHP
UT870545614BO2OtherEDUCATORS MUTUAL
UTQM0000075886OtherALTIUS
WY119019900Medicaid
NV100502001Medicaid
UT107008291102OtherIHC
UT344900OtherDESERET MUTUAL
ID806754900Medicaid
AZ828593Medicaid
UT1502954OtherUMWA
UT84183OtherHEALTHY U
UTPRA07325OtherMOLINA
UT055327107Medicare ID - Type Unspecified
UT73605OtherPEHP
AZ828593Medicaid