Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 181318-1205 | UT |
Y | 207R00000X | Internist | 181318-1205 | UT |
Y | 111NI0900X | Internist | 181318-1205 | UT |
N | 207RR0500X | Rheumatology | 181318-1205 | UT |
NPI | 1033220603 |
---|---|
Provider Name | David J Shaskey |
First Address | Salt Lake City, UT 84124-1233 |
Second Address | Salt Lake City, UT 84124-1233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 15/10/2007 |