Provider Demographics
NPI:1447228572
Name:LASH, STEPHEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:LASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 E 100 S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1501
Mailing Address - Country:US
Mailing Address - Phone:801-521-2640
Mailing Address - Fax:801-363-6407
Practice Address - Street 1:3336 S 4155 W
Practice Address - Street 2:STE 301
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120
Practice Address - Country:US
Practice Address - Phone:801-964-3865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT90-182235-1205207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTE70084Medicare UPIN
UT005548006Medicare ID - Type Unspecified