IndividualActive
Willard Dere, M.D.
NPI 1003286758 · Internal Medicine Physician · Salt Lake City, UT
Provider details
- NPI number
- 1003286758
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 01038107A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
500 Foothill Blvd
Salt Lake City, UT 84148-0001
Phone: (801) 582-1565
Approximate (ZIP-level) locationGet directions
Mailing address
15 N 2030 E
Salt Lake City, UT 84112-5339
Registry dates
- Enumerated
- 2015-10-06
- Last updated
- 2015-10-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.