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General NPI Number Information
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NPI Number | 1528115763
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Entity Type | Individual
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Provider Name | DAVID L MCCANN MD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 4190 HIGHLAND DRIVE SUITE 102
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-2600
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Country | US
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Telephone | 801-272-9205
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Fax |
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Provider Business Mailing Address
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Address Line | 7084N EARL ST
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City | PARK CITY
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State | UT
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Zip | 84098-3200
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Country | US
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Telephone | 435-647-6884
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Fax | 435-579-2603
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 154005-1205
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License Number State | UT
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