Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 7878101-1205 | UT |
NPI | 1356398010 |
---|---|
Provider Name | David E Skarda |
First Address | Salt Lake City, UT 84141-3035 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 12/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
564135700 | (05) | MN |
I21809 | (02) |