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Individual

DR. CHARLOTTE ELAINE GANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1020 S MAIN ST, SALT LAKE CITY, UT 84101-3115
(801) 539-7000
(801) 539-7050
Mailing address
1020 S MAIN ST, SALT LAKE CITY, UT 84101-3115
(801) 539-7000
(801) 539-7050

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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