Dangerfield, Shane Carlson

Dangerfield, Shane Carlson is an sole proprietor health care provider with primary practice located at 50 N Medical Dr , Salt Lake City UT 84132. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine. Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine is his primary health care specialty. Dangerfield, Shane Carlson can be contacted via phone (801) 581-2205.

Contact Information

Primary practice address
50 N Medical Dr Salt Lake City UT 84132
Phone: (801) 581-2205
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 9003692-1205 Utah
Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine 2081P0010X 4301094767 Michigan
Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine 2081P0010X 9003692-1205 Utah

Profile Details

NPI number 1457685919
LBN Legal business name Dangerfield, Shane Carlson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 30th, 2009
Last updated Dec 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457685919 NPPES
Utah MEDICAID 1457685919

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