Individual
DR. SHAD OUTSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7481
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
7365706-1205
UT
Other
Enumeration date
06/21/2008
Last updated
04/25/2022
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