Provider Demographics
NPI:1104382332
Name:ABAKUMOV, ARTEM (DC)
Entity Type:Individual
Prefix:DR
First Name:ARTEM
Middle Name:
Last Name:ABAKUMOV
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 E 830 N
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-1365
Mailing Address - Country:US
Mailing Address - Phone:435-602-9848
Mailing Address - Fax:
Practice Address - Street 1:450 W 910 S STE 106
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-2447
Practice Address - Country:US
Practice Address - Phone:435-602-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34418111N00000X, 111NX0100X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health