George W Delavan
Pediatrician
44 N Mario Capecchi Dr
Salt Lake City
, Utah 84132-0001
George W Delavan
Pediatrician
44 N Mario Capecchi Dr
Salt Lake City
, Utah 84132-0001
(801) 581-1258
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- George W Delavan
- 2691 Comanche Cir
- Salt Lake City, UT
- Zip : 84108-2807
- Phone : (801) 581-1258
Second Address
- George W Delavan
- 44 N Mario Capecchi Dr
- Salt Lake City, UT
- Zip : 84132-0001
- Fax : (801) 584-8588
- Phone : (801) 584-8239
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 160530-1205 | UT |
National Provider Identifier
| NPI | 1013003904 |
|---|---|
| Provider Name | George W Delavan |
| First Address | Salt Lake City, UT 84108-2807 |
| Second Address | Salt Lake City, UT 84132-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/10/2006 |
| Last Update Date | 01/03/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 876000545 | STATE OF UTAH DEPT. OF HEALTH (01) | UT |
| 999000021002 | (05) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.