Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 371149-1205 | UT |
Y | 2080P0205X | Pediatric Endocrinologist | 371149-1205 | UT |
NPI | 1063584290 |
---|---|
Provider Name | David L Donaldson |
First Address | Salt Lake City, UT 84158-1100 |
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 | 14/11/2006 |
Last Update Date | 02/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F26573 | (02) |