MEDICARE: DR. MICHAEL D DOWDALL 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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	161578-1205	UT
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	3697A	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548463508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL D DOWDALL M.D.

Provider Business Mailing Address
First Line	:	381 MIDDLE OAK LN
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1649
Country	:	US
Telephone Number	:	801-582-5150
Fax Number	:

Provider Business Practice Location Address
First Line	:	381 MIDDLE OAK LN
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1649
Country	:	US
Telephone Number	:	801-582-5150
Fax Number	:

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	07/08/2007

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