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Contact Information

TODD M HADERLIE, MD
1485 S HIGHWAY 40 STE E
HEBER CITY, UT84032-3522
 Phone: 435-657-4400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for TODD M HADERLIE · (Male)

NPI # 1326059155
Status Active
Credentials MD
Entity Individual
Enumeration date 08/10/2006
Last updated 03/31/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 187150-1205
  • UT License # 1871501205
Hospital affiliation(s)
  • STAR VALLEY MEDICAL CENTER - (Critical Access)
    901 ADAMS STREET
    AFTON, WY 83110
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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