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General NPI Number Information
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NPI Number | 1932385671
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Entity Type | Individual
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Provider Name | SUZANNE M YANDOW MD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 100 MARIO CAPECCHI DR 4550
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City | SALT LAKE CITY
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State | UT
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Zip | 84113-1103
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Country | US
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Telephone | 801-662-5600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 413026
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City | SALT LAKE CITY
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State | UT
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Zip | 84141-3026
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Country | US
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Telephone | 801-213-3900
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Fax |
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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 | M8442
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License Number State | TX
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