RAPHAEL NUTAKOR


Address: 1042 E Fort Union Blvd # 123, Midvale, UT 84047
Phone: 7752875508

RAPHAEL NUTAKOR (NPI# 1487071973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487071973
Entity Type Individual
Full Name RAPHAEL NUTAKOR
Practice Address 1042 E Fort Union Blvd # 123
Midvale
UT 84047
Mailing Address 48 W Inglenook Drive #720
Midvale
UT 84047
Practice Telephone 7752875508
Mailing Telephone 7752875508
Enumeration Date 2014-03-24
Last Update Date 2014-03-24
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171WH0202X Contractor
Specialization: Home Modifications
52162 UT Other Service Providers

Office Location

Street Address 1042 E FORT UNION BLVD # 123
City MIDVALE
State UT
Zip Code 84047

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Taxonomy Information

Taxonomy Code 171WH0202X
Grouping Other Service Providers
Classification Contractor
Specialization Home Modifications

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1699182212 Evolve Emod LLC Contractor 5965 S 900 E Ste 255, Salt Lake City, UT 84121-1872 2014-07-15

Competitor

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City MIDVALE
Zip Code 84047

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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