Individual
DR. SUSAN MARIE WIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
160 S 1000 E STE 220, SALT LAKE CITY, UT 84102-1552
(978) 743-9438
(844) 838-8100
Mailing address
850 E 300 S STE 1, SALT LAKE CITY, UT 84102-2301
(385) 429-9808
(844) 838-8100
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
371106
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37110612001001
BLUE CROSS BLUE SHIELD
UT
01
—
70927
PUBLIC EMPLOYEES HEALTH P
UT
01
—
870663870SW2
EMIA
UT
Enumeration date
07/27/2006
Last updated
04/04/2018
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