Healthcare Provider Details

I. General information

NPI: 1316920770
Provider Name (Legal Business Name): SHELLIE J RING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELLIE J SCHMIDTGALL MD

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3723 W 12600 S STE 330
RIVERTON UT
84065-7296
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-285-4543
  • Fax:
Mailing address:
  • Phone: 801-285-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number364200-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: