Individual
JOHN K STAHELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W, SUITE 212, PROVO, UT 84604-3305
(801) 374-2362
(801) 429-8196
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3189811205
UT
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
318981-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107008295101
IHC HEALTHPLANS
UT
01
—
110149403
PALMETTO GBA
UT
01
—
308186
DMBA
UT
01
—
44007
PEHP
UT
05
—
870281028000
—
UT
01
—
870281028ST1
EMIA
UT
01
—
QM0000000066
ALTIUS
UT
Enumeration date
05/03/2006
Last updated
12/13/2024
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