Individual
DR. RICHARD E. KANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-7806
Mailing address
PO BOX 581700, SALT LAKE CITY, UT 84158-1700
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
151143-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000068200
—
ID
01
—
111157428
RAILROAD MEDICARE
UT
05
—
94001682
—
CO
Enumeration date
10/13/2006
Last updated
12/20/2021
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