Provider Demographics
NPI:1417972571
Name:TRACHTENBERG, JOEL D (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:D
Last Name:TRACHTENBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1160 EAST 3900 SOUTH
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124
Mailing Address - Country:US
Mailing Address - Phone:801-261-9651
Mailing Address - Fax:801-261-9656
Practice Address - Street 1:1160 E 3900 SOUTH
Practice Address - Street 2:SUITE 1200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124
Practice Address - Country:US
Practice Address - Phone:801-261-9651
Practice Address - Fax:801-261-9656
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT4912613-8905207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTH98999Medicare UPIN