Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 7470082-1208 | UT |
Y | 2084N0402X | Child Neurologist | 7470082-1205 | UT |
NPI | 1154575843 |
---|---|
Provider Name | Dr. Meghan Sullivan Candee |
First Address | Salt Lake City, UT 84141-3021 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2008 |
Last Update Date | 11/11/2021 |