Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 9601925-1205 | UT |
Y | 2080A0000X | Adolescent Medicine | 9601925-1205 | UT |
NPI | 1184044877 |
---|---|
Provider Name | Dr. Adam Wesley Dell |
First Address | Salt Lake City, UT 84132-0002 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 20/10/2021 |