Individual
DR. SHANNON ROSE BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-5701
Mailing address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-5701
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11393165-1205
UT
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
11393165-1205
UT
Other
Enumeration date
04/19/2018
Last updated
05/24/2022
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