Provider Demographics
NPI:1427314764
Name:OGITANI, DAVIS WENDELL (MD)
Entity type:Individual
Prefix:
First Name:DAVIS
Middle Name:WENDELL
Last Name:OGITANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 HARRISON BLVD
Mailing Address - Street 2:HOSPITALIST OFFICE
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403
Mailing Address - Country:US
Mailing Address - Phone:801-387-3364
Mailing Address - Fax:801-387-3259
Practice Address - Street 1:4401 HARRISON BLVD
Practice Address - Street 2:HOPSITALIST OFFICE
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-387-3364
Practice Address - Fax:801-387-3259
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9751087-1205208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist