Provider Demographics
NPI:1730193053
Name:ABELE, JOAN CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:CATHERINE
Last Name:ABELE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:5121 S COTTONWOOD STREET
Practice Address - Street 2:INTERMOUNTAIN MEDICAL CENTER
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84157
Practice Address - Country:US
Practice Address - Phone:801-507-5248
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT93-169747-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT10703OtherDMBA
UT8187OtherPEHP
UT1502954OtherUMWA
UT703OtherHEALTHY U
WY101416100Medicaid
UT107004843101OtherIHC
UT8597445OtherWORKERS COMP FUND
UT870545614AB1OtherEDUCATORS
ID000169400Medicaid
UTPRA06346OtherMOLINA
UTQM0000075886OtherALTIUS
UTZ51320OtherOUT OF STATE BCBS
NV002088833Medicaid
UT2090168OtherUNITED HEALTHCARE
AZ821703Medicaid
ID000169400Medicaid
UT005532701Medicare PIN