Provider Demographics
NPI:1508684093
Name:WINN, MACI
Entity type:Individual
Prefix:DR
First Name:MACI
Middle Name:
Last Name:WINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Mailing Address - Street 2:27 SOUTH MARIO CAPECCHI DRIVE
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Practice Address - Street 2:27 SOUTH MARIO CAPECCHI DRIVE
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84113
Practice Address - Country:US
Practice Address - Phone:801-842-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program