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Individual

ETHAN PATRICK BAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4403 HARRISON BLVD STE 700A, OGDEN, UT 84403-3295
(801) 387-5300
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11217835-1204
UT

Other

Enumeration date
04/29/2016
Last updated
04/13/2026
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