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Contact Information

SAMUEL M BERTOCH, FNP-C
2750 NORTH 2762 WEST
ROOSEVELT, UT84066
 Phone: 435-722-9250
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SAMUEL M BERTOCH · (Male)

NPI # 1417525544
Status Active
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 06/15/2021
Last updated 06/15/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 327174-4405
Hospital affiliation(s)
  • ASHLEY VALLEY MEDICAL CENTER - (Acute Care)
    150 WEST 100 NORTH
    VERNAL, UT 84078
  • UINTAH BASIN MEDICAL CENTER - (Acute Care)
    250 WEST 300 NORTH (75-2)
    ROOSEVELT, UT 84066
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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