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NPI Code Detail

MEDICARE: CAROLE HANNAH STIPELMAN M.D.

MEDICARE: CAROLE HANNAH STIPELMAN M.D.
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
1208000000XPediatrics Physician377568-1205UT

General Provider Information

NPI Number : 1851496616
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE HANNAH STIPELMAN M.D.
Provider Business Mailing Address
First Line : 972 YALE AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-1423
Country : US
Telephone Number : 801-575-5398
Fax Number :
Provider Business Practice Location Address
First Line : 461 S 400 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3302
Country : US
Telephone Number : 801-539-8617
Fax Number : 801-537-7238
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 11/23/2021

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Directions to “ CAROLE HANNAH STIPELMAN M.D.” Practice Location

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