Individual
SHALEEN DOCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 N MAIN ST, BOUNTIFUL, UT 84010-6046
(801) 397-6400
(801) 396-6439
Mailing address
390 N MAIN ST, BOUNTIFUL, UT 84010-6046
(801) 397-6400
(801) 397-6439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12857581
UT
207Q00000X
Family Medicine Physician
MD204302
OR
390200000X
Student in an Organized Health Care Education/Training Program
MED-RES-LIC-67437
MT
Other
Enumeration date
04/20/2018
Last updated
03/26/2024
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