Provider Demographics
NPI:1750578852
Name:STARR, MILTON NATHAN (DO)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:NATHAN
Last Name:STARR
Suffix:
Gender:M
Credentials:DO
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 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-408-5482
Mailing Address - Fax:801-408-5481
Practice Address - Street 1:8TH AVENUE AND C STREET
Practice Address - Street 2:LDS HOSPITAL HOSPITALISTS
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84143-0001
Practice Address - Country:US
Practice Address - Phone:801-408-5482
Practice Address - Fax:801-408-5481
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT361986-1204207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000063881Medicare PIN