Individual
SCOTT ALLEN ANDELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4403 HARRISON BLVD, STE A-700, OGDEN, UT 84403-3271
(801) 387-5300
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-5300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2012003966
MO
207Q00000X
Family Medicine Physician
Primary
7730028-1205
UT
208M00000X
Hospitalist Physician
2012003966
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013245000
—
UT
Enumeration date
12/02/2009
Last updated
11/12/2024
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