Provider Demographics
NPI:1326200627
Name:MUIR, GARTH JAMES (MD)
Entity Type:Individual
Prefix:
First Name:GARTH
Middle Name:JAMES
Last Name:MUIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84011-0307
Mailing Address - Country:US
Mailing Address - Phone:801-550-1121
Mailing Address - Fax:801-935-9555
Practice Address - Street 1:822 E GOLDEN PHEASANT DR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8456
Practice Address - Country:US
Practice Address - Phone:801-550-1121
Practice Address - Fax:801-935-9555
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8525148-1205207R00000X
WA60256633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine