Provider Demographics
NPI:1720198716
Name:WINTERS, WILLIAM D (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:WINTERS
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 1:869 E 4500 SO.
Mailing Address - Street 2:PMB #511
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3049
Mailing Address - Country:US
Mailing Address - Phone:801-487-0451
Mailing Address - Fax:801-487-2467
Practice Address - Street 1:100 NO MARIO CAPECCHI DR.
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113
Practice Address - Country:US
Practice Address - Phone:801-662-1900
Practice Address - Fax:801-662-1810
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4856472-12052085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT35834OtherDESERET MUTUAL
UT107009076101OtherSELECTHEALTH
UT870355724WWDOtherEDUCATORS MUTUAL
UT1600094OtherUNITED HEALTHCARE
UT48564721200001OtherBLUE SHIELD
UT9677OtherUUHN
UT63215OtherPUBLIC EMPLOYEES HEALTH
UT8550895OtherAETNA
UTQM0000027099OtherALTIUS
UT9677OtherUUHN
UT1600094OtherUNITED HEALTHCARE