Provider Demographics
NPI:1831193879
Name:MAJOR, MICHAEL R (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:MAJOR
Suffix:
Gender:M
Credentials:MD
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:435-251-3700
Mailing Address - Fax:435-251-3701
Practice Address - Street 1:652 SOUTH MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-251-3700
Practice Address - Fax:435-251-3701
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20153207X00000X, 207XS0117X
UT7383775-1205207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30554100Medicaid
200010930OtherRAILROAD MEDICARE
WI30554100Medicaid
200010930OtherRAILROAD MEDICARE
B54771Medicare UPIN