Basic Information
| Provider Information | |||||||||
| NPI: | 1851496616 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STIPELMAN | ||||||||
| FirstName: | CAROLE | ||||||||
| MiddleName: | HANNAH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 972 YALE AVE | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841051423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015755398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 461 S 400 E | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841113302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015398617 | ||||||||
| FaxNumber: | 8015377238 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 377568-1205 | UT | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.