Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 217788 | NC |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 11705712-1205 | UT |
NPI | 1134576937 |
---|---|
Provider Name | Susan E. Dalton |
First Address | Salt Lake City, UT 84132-2209 |
Second Address | Salt Lake City, UT 84132-2209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2016 |
Last Update Date | 18/10/2021 |