Individual
TERRI A. DEJOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
540 ARAPEEN DR, SALT LAKE CITY, UT 84108-1250
(801) 582-4268
(801) 582-4269
Mailing address
540 ARAPEEN DR, STE #110, SALT LAKE CITY, UT 84108-1250
(801) 582-4268
(801) 582-4269
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
164427-1205
UT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
164427-1205
UT
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
164427-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06268
—
UT
01
—
105987500
DEPT OF LABOR
UT
01
—
238704
ALTIUS
UT
01
—
891
HEALTHY U MEDICAID
UT
01
—
930091526
RAILROAD MEDICARE
UT
01
—
MD672UT
ALASKA MEDICAID
UT
01
—
P00235891
RAILROAD MEDICARE
UT
Enumeration date
03/15/2006
Last updated
04/21/2010
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