NPI

Maxi Edra Dax

This page is a copy of the public NPPES file.

Facts

Status
Active
Credential
PA
Type
Individual
Enumeration date
2016-09-14
Last updated
2024-01-25

Specialties

Licenses

License UT
10079306-1206

Location

Practice location
200 North 400 East
City
Panguitch UT
Postal code
84759
Phone
(435) 690-1246

Medicare

PECOS
A PECOS enrollment row matches this NPI.

LEIE

No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.

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Nearby

Other NPIs in Panguitch, UT. 51 records in the public file.

Removal request

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