Healthcare Provider Details

I. General information

NPI: 1740436625
Provider Name (Legal Business Name): HU DING, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 EAST MEDICAL DR
BOUNTIFUL UT
84010
US

IV. Provider business mailing address

PO BOX 727
BRIGHAM CITY UT
84302-0727
US

V. Phone/Fax

Practice location:
  • Phone: 801-299-2125
  • Fax:
Mailing address:
  • Phone: 435-734-0101
  • Fax: 435-734-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number5298365-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number5298365-1205
License Number StateUT

VIII. Authorized Official

Name: HU DING
Title or Position: OWNER
Credential: M.D.
Phone: 435-734-0101