Provider Demographics
NPI:1386074466
Name:PIERCE, MATTHEW
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:PIERCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7181 S CAMPUS VIEW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4312
Mailing Address - Country:US
Mailing Address - Phone:801-965-3600
Mailing Address - Fax:
Practice Address - Street 1:9844 S 1300 E
Practice Address - Street 2:#100
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4673
Practice Address - Country:US
Practice Address - Phone:801-571-9433
Practice Address - Fax:814-308-8584
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2024-12-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant