Most Relevant Information
Provider Data
| NPI Number: | 1003286758 |
| Provider Name: | WILLARD DERE M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 01038107A |
Most Important Dates
| Enumeration Date: | 10/06/2015 |
| Last Updated: | 10/06/2015 |
Provider Practice Location
500 FOOTHILL BLVD
SALT LAKE CITY
UT
841480001
Practice Location Phone/Fax
| Phone: | 8015821565 |
| Fax: |
Provider Mailing Location
15 N 2030 E
ROOM 2160A
SALT LAKE CITY
UT
841125339
Provider Mailing Phone/Fax
| Phone: | 8015852516 |
| Fax: |
Suggested EMR
Internist EMR