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Individual

DR. MARK RAPAPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
501 S CHIPETA WAY RM 1838, SALT LAKE CITY, UT 84108-1222
(801) 587-8626
Mailing address
501 S CHIPETA WAY RM 1838, SALT LAKE CITY, UT 84108-1222
(801) 587-8626

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G50476
CA
2084P0800X
Psychiatry Physician
066799
GA
2084P0800X
Psychiatry Physician
Primary
12199014-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G504760
CA
Enumeration date
12/05/2005
Last updated
12/01/2021
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