Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 56554231205 | UT |
NPI | 1093728115 |
---|---|
Provider Name | Mark J Sheffield |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Ogden, UT 84403-3195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 11/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093728115 | (05) | UT |
5655423-1205 | PROFESSIONAL STATE LICENSE (01) | UT |