IndividualActive
Frederic Civish
NPI 1124137278 · Family Medicine Physician · West Valley, UT
Provider details
- NPI number
- 1124137278
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- 184916-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3534 S 6000 W
West Valley, UT 84128-2610
Phone: (801) 969-6264
Fax: (801) 969-6333
Approximate (ZIP-level) locationGet directions
Mailing address
3354 W 7800 S
West Jordan, UT 84088-4506
Registry dates
- Enumerated
- 2006-08-30
- Last updated
- 2017-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.