Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 5532376 | UT |
Y | 2080P0203X | Pediatric Critical Care Doctor | 5532376-1205 | UT |
NPI | 1255410726 |
---|---|
Provider Name | Michelle Elena Schober |
First Address | Salt Lake City, UT 84158-1100 |
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 | 03/11/2006 |
Last Update Date | 23/11/2021 |