Individual
SHAWN DAVID MCQUILKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
WSU STUDENT HEALTH CENTER, 1128 UNIVERSITY CIRCLE, OGDEN, UT 84408-1128
(801) 626-6459
(801) 626-7786
Mailing address
1541 WASATCH DR, OGDEN, UT 84403-1422
(801) 475-5017
(801) 475-5017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
176177-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001352
PIN OGDEN
UT
01
—
176177 1205
STATE LICENSE NUMBER
UT
Enumeration date
03/23/2007
Last updated
07/08/2007
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