Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 2002-01109 | NC |
N | 207RH0003X | Hematology & Oncology | 8654924-1205 | UT |
Y | 207RX0202X | Medical Oncology | 8654924-1205 | UT |
NPI | 1033293196 |
---|---|
Provider Name | Stephan D Kendall |
First Address | Salt Lake City, UT 84124-1214 |
Second Address | Salt Lake City, UT 84106-1466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 10/10/2016 |