Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Patrick Baham, DO

Individual provider Family Medicine Physician · NPI 1740635556

Ethan Patrick Baham, DO is a Family Practice in Ogden, Utah. Qualified in 2016, 10 years ago. Practices with Tanner Memorial Clinic, a 252-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
10
Licensed in
UT
In the registry since
2016
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4403 Harrison Blvd Ste 700A
Ogden, UT 84403-3295
Phone: (801) 387-5300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 11217835-1204 (UT)

Record details

NPI number1740635556
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 29, 2016
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Tanner Memorial Clinic — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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