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Individual
STEPHEN R SHUPUT
Active
Individual
STEPHEN R SHUPUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
82-169038-1205
UT
207L00000X
Anesthesiology Physician
Primary
G52161
CA
207L00000X
Anesthesiology Physician
MD27419
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003075300
—
ID
05
—
006393
—
OR
05
—
100501223
—
NV
01
—
107005104101
IHC
UT
05
—
108049100
—
WY
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
36407
DESERET MUTUAL
UT
01
—
37817
PEHP
UT
01
—
53268
HEALTHY U
UT
05
—
820838
—
AZ
05
—
8492795
—
WA
01
—
8597445
WORKERS COMP
UT
01
—
870545614SH1
EDUCATORS MUTUAL
UT
01
—
P00611182
RR MEDICARE
OR
01
—
PRA05848
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
08/31/2006
Last updated
09/19/2023
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