Provider Demographics
NPI:1578752218
Name:CHRISTOPHER, MATTHEW (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9690 S 1300 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3721
Mailing Address - Country:US
Mailing Address - Phone:801-571-5121
Mailing Address - Fax:801-572-5358
Practice Address - Street 1:9690 S 1300 E
Practice Address - Street 2:SUITE 100
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3721
Practice Address - Country:US
Practice Address - Phone:801-571-5121
Practice Address - Fax:801-572-5358
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2021-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT311061-1206363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical