Individual
SCOTT JAMES SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
389 S 900 E, STE 100, SALT LAKE CITY, UT 84102-2310
(385) 282-2125
(385) 282-2126
Mailing address
1121 E 3900 S, STE C-240, SALT LAKE CITY, UT 84124-1214
(801) 266-0878
(801) 266-2074
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
5918534-1205
UT
207RX0202X
Medical Oncology Physician
Primary
5918534-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107065766102
SELECT HEALTH
UT
Enumeration date
11/11/2007
Last updated
10/10/2016
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