Shannon R Staker MD

NPI 1023078045 - Pediatrics - 208000000X

NPI Details
NPI 1023078045
Gender Female
Enumeration Date 03/24/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
210 W 300 N 75-3
ROOSEVELT UT, 84066, US
Phone (435) 722-3971
Fax (435) 722-6104
Business Location
210 W 300 N 75-3
ROOSEVELT UT, 84066, US
Phone (435) 722-3971
Fax (435) 722-6104
Toxanomy
Taxonomy Code 208000000X
License State Utah
License Number 49110641205
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According to our database, Dr. Shannon R Staker MD NPI is 1023078045, taxonomy code is 208000000X and license number is 49110641205, license state is located at Utah. Shannon R Staker MD physically located at 210 W 300 N 75-3, Roosevelt UT, 84066. NPI Number Shannon R Staker MD has the Individual type.

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1023078045 NPI number is provided on an as is basis without warranty of any kind. 1023078045 is maintained by the National Plan & Provider Enumeration System. The contents of Shannon R Staker MD are for informational purposes only.