Basic Information
| Provider Information | |||||||||
| NPI: | 1659725851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEVALA-PLAGEMANN | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | DUANE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 N 1900 E # SOM | ||||||||
| Address2: | DEPARTMENT OF MEDICINE - ROOM 4C116 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841320002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015817899 | ||||||||
| FaxNumber: | 8015850418 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 N 1900 E # SOM | ||||||||
| Address2: | DEPARTMENT OF MEDICINE - ROOM 4C116 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841320002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015817899 | ||||||||
| FaxNumber: | 8015850418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2016 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 10514857-1205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.