Individual
DR. CHRISTOPHER M SHALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4403 HARRISON BLVD, STE 4835, OGDEN, UT 84403-3271
(801) 387-4750
(801) 387-4755
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-4755
(801) 442-0643
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
N1138
TX
208200000X
Plastic Surgery Physician
Primary
8501536-1205
UT
208600000X
Surgery Physician
N1138
TX
208D00000X
General Practice Physician
N1138
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U000078865
PTAN
UT
Enumeration date
02/23/2006
Last updated
08/12/2021
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