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Individual
DR. BRENT S. CHILD
Active
Individual
DR. BRENT S. CHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
163630-1205
UT
207L00000X
Anesthesiology Physician
79-163630-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002082843
—
NV
05
—
003619600
—
ID
01
—
107005371101
IHC
UT
05
—
110169200
—
WY
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
05
—
288177
—
AZ
01
—
3252
HEALTHY U
UT
01
—
36621
DESERET MUTUAL
UT
01
—
37777
PEHP
UT
01
—
8597445
WORKERS COMP FUND
UT
01
—
870545614CH2
EDUCATORS MUTUAL
UT
01
—
PRA05761
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
08/05/2006
Last updated
10/15/2012
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