MICHAEL CHAD MAHAN (NPI# 1811316847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811316847 |
| Entity Type | Individual |
| Full Name | MICHAEL CHAD MAHAN |
| Credential | M.D. |
| Practice Address |
590 S Wakara Way Salt Lake City UT 84108-1200 |
| Practice Telephone | 8015875400 |
| Mailing Telephone | 8015875400 |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 11265662-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
11265662-1205 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2799 W Grand Blvd, Henry Ford Hospital Medical Education Department, Detroit, MI 482022608 | 3139162600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942500608 | Michael R Mahan | Physical Therapist | 830 Falls Creek Dr., Vandalia, OH 45377-9415 | 2010-10-28 |
| 1063921476 | Michael Craig Mahan | Physical Medicine & Rehabilitation | 2490 Willamette St Ste 5, Eugene, OR 97405-7211 | 2017-09-28 |
| 1730634072 | Michael Mahan | Counselor | 6633 E Highway 290, Suite 212, Austin, TX 78723-1172 | 2016-08-16 |
| 1265844922 | Michael Orin Mahan | Chiropractor | 1606 S Commercial Ave, Coleman, TX 76834-5018 | 2014-05-28 |
| 1962658914 | Michael J Mahan | Counselor | 3711 Long Beach Blvd, Suite 600, Long Beach, CA 90807-3315 | 2008-08-11 |
| 1922038892 | Michael A Mahan | Family Medicine | 610 W Adams St, Black River Falls, WI 54615-9010 | 2006-07-04 |
| 1518959659 | Michael M Mahan | Chiropractor | 214 S Mountain St, Union, SC 29379-2331 | 2005-08-16 |
| Street Address |
590 S WAKARA WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174524862 | Kimberly M Ross | Occupational Therapist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2005-08-03 |
| 1558988717 | Logan James Couce | Physical Therapist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-07-02 |
| 1457976581 | Abigail Bigham | Physical Therapist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-06-15 |
| 1073141768 | Matthew Jiajing Siebert | Student in an Organized Health Care Education/Training Program | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-03-30 |
| 1326676370 | Joshua Paul Rainey | Student in an Organized Health Care Education/Training Program | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-03-27 |
| 1407483886 | Olivia Grothaus | Student in an Organized Health Care Education/Training Program | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-03-25 |
| 1316574775 | Eleanor Hope Sato | Student in an Organized Health Care Education/Training Program | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-03-25 |
| 1922632959 | Alexander John Reese | Pharmacist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2020-02-28 |
| 1679110548 | Byron C Miller | Physical Therapist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2019-12-10 |
| 1851933501 | Gabrielle Lecheminant Grimmer | Physician Assistant | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2019-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292446 | Bruce G Evans | Orthopaedic Surgery | 1160 East 3900 South, Suite 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1740676394 | Matthew C. Christie | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2015-04-10 |
| 1437579893 | Steven Donohoe | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-04-23 |
| 1548410608 | G Lynn Rasmussen Md PC | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Salt Lake City, UT 84107-6121 | 2008-09-25 |
| 1366624991 | Nathan G Momberger Md PC | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Salt Lake City, UT 84107-6121 | 2007-12-05 |
| 1568456242 | Kim C Bertin | Orthopaedic Surgery | 24 S 1100 E, Ste 101, Salt Lake City, UT 84102-1500 | 2005-09-08 |
| 1073505582 | Michael H Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083953558 | Russell L Nelson, M.d. PC | Orthopaedic Surgery | 5323 S Woodrow St Ste 200, Murray, UT 84107-5844 | 2013-02-04 |
| 1669416129 | John M Hillyard | Orthopaedic Surgery | 1899 E Mystic Grove Cv, Cottonwood Heights, UT 84093-5509 | 2006-06-15 |
| 1063645554 | Yvonne Potter Fuellenbach | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Murray, UT 84107-6121 | 2009-08-31 |
| 1326286972 | Peter G. Larcom Md PC | Orthopaedic Surgery | 5323 South Woodrow Street Suite 200, Murray, UT 84107 | 2009-02-04 |
| 1366460420 | G Lynn Rasmussen | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Murray, UT 84107-6121 | 2006-07-17 |
| 1467486795 | Nathan G Momberger | Orthopaedic Surgery | 5848 Fashion Blvd Ste 110, Murray, UT 84107-6121 | 2006-07-11 |
| 1821029869 | Peter G Larcom | Orthopaedic Surgery | 5316 S Woodrow St Ste 200, Murray, UT 84107-5838 | 2006-07-06 |
| City | SALT LAKE CITY |
| Zip Code | 84108 |
Please comment or provide details below to improve the information on MICHAEL CHAD MAHAN.
| 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.