Provider Demographics
NPI:1437331352
Name:WASATCH CARDIOLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:WASATCH CARDIOLOGY CONSULTANTS PC
Other - Org Name:PEAK HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAWLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-293-7001
Mailing Address - Street 1:6011 S REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5220
Mailing Address - Country:US
Mailing Address - Phone:801-293-7001
Mailing Address - Fax:801-293-9500
Practice Address - Street 1:6011 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5220
Practice Address - Country:US
Practice Address - Phone:801-293-7001
Practice Address - Fax:801-293-9500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAK HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-03
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT174435-1205207Q00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT060061547OtherMEDICARE PTAN
UTU000058100OtherPTAN
UT000058100OtherTPAN
UTU000058100OtherPTAN