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Individual

DR. MARK ANDREW SUPIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
UNIVERSITY OF UTAH HEALTHCARE, 30 NORTH 1900 EAST; AB193 SOM, SALT LAKE CITY, UT 84132-0001
(801) 587-9103
(801) 585-3384
Mailing address
30 N 1900 E, SOM AB193, SALT LAKE CITY, UT 84132-0002
(801) 587-9103
(801) 585-3384

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
5956337-1205
UT

Other

Enumeration date
07/27/2006
Last updated
11/23/2021
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