Individual
DR. SHAWN DALE ISAEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
955 CHAMBERS ST STE 200, OGDEN, UT 84403-4519
(801) 252-6774
(801) 515-0165
Mailing address
955 CHAMBERS ST STE 200, OGDEN, UT 84403-4519
(801) 252-6774
(801) 515-0165
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24914
OK
2085R0202X
Diagnostic Radiology Physician
MD34076
TN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
11513652-1205
UT
2085R0204X
Vascular & Interventional Radiology Physician
C55447
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247622001
MEDICARE
OK
01
—
247622002
MEDICARE
OK
05
—
3850918
—
TN
01
—
P00345589
RAILROAD MEDICARE
OK
Enumeration date
03/02/2006
Last updated
12/29/2025
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