Individual
SHANE MICHAEL WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(440) 263-8777
Mailing address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 581-7914
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11405599-1205
UT
Other
Enumeration date
04/03/2018
Last updated
09/12/2019
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