Individual
DR. LEE CARL SCHUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 N WASHINGTON BLVD, NORTH OGDEN, UT 84414-7233
(801) 786-7500
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 786-7500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1553861205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04741
—
UT
Enumeration date
11/08/2006
Last updated
07/09/2008
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