# SUSAN C HUSTAD MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447470893
- **Authorized official:** SUSAN C HUSTAD MD (PRESIDENT)
- **Authorized official phone:** (801) 475-8600

## Contact information

- **Practice address:** 425 E 5350 S, STE 335, OGDEN, UT 84405-6946
- **Practice address phone:** (801) 475-8600
- **Practice address fax:** (801) 475-8686
- **Mailing address:** 425 E 5350 S, STE 335, OGDEN, UT 84405-6946
- **Mailing address phone:** (801) 475-8600
- **Mailing address fax:** (801) 475-8686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 377470-1205 | UT | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 08/16/2007