Bostrom, Samantha P
Bostrom, Samantha P is an individual health care provider with primary practice located at 1477 North 2000 West Suite C, Clinton UT 84015-8213. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bostrom, Samantha P can be contacted via phone (801) 774-8888.Contact Information
Primary practice address
1477 North 2000 West Suite C
Clinton UT 84015-8213
Phone: (801) 774-8888
Fax: (801) 825-8519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 327457-1205 | Utah |
Profile Details
| NPI number | 1881801579 |
|---|---|
| LBN Legal business name | Bostrom, Samantha P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2007 |
| Last updated | Aug 12th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881801579 | NPPES |
| Utah | MEDICAID | D2612 |
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