MEDICARE: STEPHEN D LASH 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
1	207VX0000X	Obstetrics Physician	90-182235-1205	UT

General Provider Information

NPI Number	:	1447228572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN D LASH M.D.

Provider Business Mailing Address
First Line	:	1060 E 100 S
Second Line	:	SUITE 400
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1501
Country	:	US
Telephone Number	:	801-521-2640
Fax Number	:	801-363-6407

Provider Business Practice Location Address
First Line	:	3336 S 4155 W
Second Line	:	STE 301
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120
Country	:	US
Telephone Number	:	801-964-3865
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/10/2023

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