Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 315081-1205 | UT |
NPI | 1518916782 |
---|---|
Provider Name | Richard W Hendershot |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84102-2310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 13/11/2015 |