Individual
DR. CHARLOTTE ELAINE GANT
Active
Individual
DR. CHARLOTTE ELAINE GANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
831704181205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002200221
RAILROAD MEDICARE
UT
01
—
107006815101
INTERMOUNTAIN HEALTH CARE
UT
01
—
261775
DESERET MUTUAL
UT
01
—
831704181205
STATE MEDICAL LICENSE
UT
01
—
942938348GA1
EDUCATORS MUTUAL
UT
01
—
A97112
MEDICARE ADVANTAGE
UT
01
—
XXXX01001
BLUE CROSS
—
Enumeration date
12/28/2005
Last updated
03/07/2023
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