Individual
STEPHANIE LYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
175 NORTH MEDICAL DRIVE EAST, SALT LAKE CITY, UT 84132-0001
(801) 585-6387
Mailing address
175 NORTH MEDICAL DRIVE EAST, SALT LAKE CITY, UT 84132-0001
(801) 585-6387
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125067394
IL
2084N0400X
Neurology Physician
125067394
IL
2084V0102X
Vascular Neurology Physician
Primary
11250301-1205
UT
Other
Enumeration date
06/16/2015
Last updated
11/18/2021
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