MICHAEL DAVID ENGELBERT-FENTON (NPI# 1194701920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194701920 |
| Entity Type | Individual |
| Full Name | MICHAEL DAVID ENGELBERT-FENTON |
| Credential | PA-C |
| Practice Address |
150 S 1000 E Salt Lake City UT 84102-1443 |
| Mailing Address |
6275 Snowview Dr Park City UT 84098-6118 |
| Practice Telephone | 8013634071 |
| Mailing Telephone | 4356457852 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2009-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 102950-1206 | UT | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
102950-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
150 S 1000 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-1443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639357593 | David R Masihdas Odpc | Optometrist | 150 S 1000 E, Salt Lake City, UT 84102-1443 | 2008-02-03 |
| 1235131475 | Lawrence Vincent Larsen | Allergy & Immunology | 150 S 1000 E, Salt Lake City, UT 84102-1443 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748080 | Shannon Dhungel | Physician Assistant | 82 S 1100 E Ste 402, Salt Lake City, UT 84102-1892 | 2020-04-10 |
| 1528533825 | Ryan Mclean Walsh | Physician Assistant | 1454 University Vlg, Salt Lake City, UT 84108-3518 | 2018-10-12 |
| 1033627351 | Linda Richards Lewis | Physician Assistant | 30 N. 1900 E, Som 5r218, Salt Lake City, UT 84132-0002 | 2018-01-22 |
| 1972036242 | Jace Meng | Physician Assistant | 30 N 1900 E Rm 5r218, Salt Lake City, UT 84132-0002 | 2017-04-04 |
| 1710372784 | Sarah Beth Wills | Physician Assistant | 500 Foot Drive, Salt Lake City, UT 84148-4004 | 2015-04-06 |
| 1821323742 | Sara Diane Feltz | Physician Assistant | 615 Arapeen Drive, Suite 100, Salt Lake City, UT 84108 | 2009-10-09 |
| 1457597809 | Wesley Messer Norwood | Physician Assistant | 150 S 1000 E Ste 200, Salt Lake City, UT 84102-1496 | 2009-01-06 |
| 1235146937 | Kara Alexander-agresta | Physician Assistant | 3838 S 700 E Utah Cancer Specialist-cancer Ctr, Suite 100, Salt Lake City, UT 84106 | 2006-08-02 |
| 1669459301 | Steven Eugene Nickman | Physician Assistant | 8th Avenue & C Street, Lds Hospital E8/ibmt Program, Salt Lake City, UT 84143 | 2005-12-23 |
| 1912515230 | Lesly Pineda | Physician Assistant | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-07-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
Please comment or provide details below to improve the information on MICHAEL DAVID ENGELBERT-FENTON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.