Organization
STANSBURY PEDIATRICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEIDI S MCMILLAN MD (OWNER)
(435) 882-1288
Entity
Organization
Contact information
Practice address
210 MILLPOND, STANSBURY PARK, UT 84074
(435) 882-1288
(435) 882-1275
Mailing address
PO BOX 932, SANDY, UT 84091-0932
(801) 553-9568
(801) 553-9562
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
5904241-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022588131001
—
UT
Enumeration date
05/03/2007
Last updated
08/22/2020
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