Provider Demographics
NPI:1780822809
Name:GINGELL, DANA CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:CLAIRE
Last Name:GINGELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 E SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2236
Mailing Address - Country:US
Mailing Address - Phone:650-817-5915
Mailing Address - Fax:
Practice Address - Street 1:1372 S 300 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-1502
Practice Address - Country:US
Practice Address - Phone:650-817-5915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8411749-8017207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology