Dahlke, Devon E.

Dahlke, Devon E. is an individual health care provider with primary practice located at 630 E 1400 N Ste 150 , Logan UT 84341-2549. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Dahlke, Devon E. can be contacted via phone (435) 915-4465.

Contact Information

Primary practice address
630 E 1400 N Ste 150 Logan UT 84341-2549
Phone: (435) 915-4465
Fax: (435) 514-4556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 5703274-1206 Utah
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1598866691
LBN Legal business name Dahlke, Devon E.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Dec 1st, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598866691 NPPES
Utah Other $$$$$$$$$ CHAMPUS
Utah MEDICAID 1598866691 CHAMPUS

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