MEDICARE: DR. DAVID IRA CLUFF DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	6994562-4405	UT
2	363LA2100X	Acute Care Nurse Practitioner	6994562-4405	UT

General Provider Information

NPI Number	:	1700314085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID IRA CLUFF DNP

Provider Business Mailing Address
First Line	:	1264 W VILLAGE MAIN DR UNIT A
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-1952
Country	:	US
Telephone Number	:	801-972-0393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1264 W VILLAGE MAIN DR UNIT A
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-1952
Country	:	US
Telephone Number	:	801-972-0393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	01/30/2025

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