Individual
MICHAEL CHAD MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5400
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5400
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
11265662-1205
UT
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
11265662-1205
UT
Other
Enumeration date
04/07/2014
Last updated
06/12/2019
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