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Individual

STEVEN L WALLENTINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1055 N 500 W, SUITE 202, PROVO, UT 84604-3305
(801) 374-2367
(801) 429-8015
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
60986311205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107046686101
IHC
UT
01
285195
ALTIUS
UT
01
36-00187
UHC
UT
01
6098631120000
BCBS
UT
05
870281028000
UT
01
87028102800B
EMIA
UT
01
88780
PEHP
UT
01
933849
DMBA
UT
01
I62333
UPIN
UT
01
P00345446
PALMETTO
UT
Enumeration date
05/12/2006
Last updated
11/27/2023
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