Provider / Organization | NPI | Date Certified |
---|---|---|
MAITE ANTOLA | 1518584655 | 2020-07-05 |
Maite Antola is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1518584655. Registration indicates Maite Antola is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians)
Entity Type | Individual |
Provider Name | Maite Antola |
Practice Office Address | 421 N OREM BLVD OREM, UT US |
Practice Office Telephone | 8017640200 |
Practice Office Fax | 8017640206 |
Mailing Address | 421 N OREM BLVD OREM, UT 840578813 US |
Business Telephone | 8017640200 |
Business Fax | 8017640206 |
Code | Practice | License No State |
---|---|---|
390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
207R00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Internal MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine Allopathic & Osteopathic Physicians Internal Medicine Primary Care/Family Planning/APRN/PA Internal Medicine Allopathic & Osteopathic Physicians | 11971127-1206
UT |