Individual
MARK SEDERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5400
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-5400
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
11741897-1204
UT
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
11741897-1204
UT
Other
Enumeration date
03/25/2016
Last updated
06/11/2020
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