Individual
DAN DAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4403 HARRISON BLVD STE 3450, OGDEN, UT 84403
(801) 387-3850
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(404) 351-5983
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
039084
GA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
039084
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000907288NOPRSTUVWXY
—
GA
Enumeration date
06/16/2005
Last updated
09/16/2021
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