Individual
DR. SHERYLL LAND VANDERHOOFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112-8924
(801) 581-2955
Mailing address
PO BOX 3208, SALT LAKE CITY, UT 84110-3208
(801) 587-6340
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2752851205
UT
207NP0225X
Pediatric Dermatology Physician
Primary
2752851205
UT
207NS0135X
Procedural Dermatology Physician
2752851205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000W4615
—
NM
05
—
002087219
—
NV
05
—
003054400
—
ID
05
—
0098209
—
MT
05
—
10025133700
—
NE
05
—
393158
—
AZ
05
—
870468377001
—
UT
05
—
MD391UT
—
AK
Enumeration date
10/25/2006
Last updated
12/20/2021
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