Individual
DR. ROSS BRIGHAM DASTRUP
Active
Individual
DR. ROSS BRIGHAM DASTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
7536235-1205
UT
207P00000X
Emergency Medicine Physician
PENDING
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902023773
—
UT
Enumeration date
04/20/2007
Last updated
10/01/2010
Update your record
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