Individual
MARK L DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2976 CHEROKEE LN STE 111, PROVO, UT 84604-4356
(801) 687-7575
Mailing address
2976 CHEROKEE LN, PROVO, UT 84604-4356
(801) 687-7575
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
1678601205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-00069
UNITED HEALTHCARE
UT
01
—
070003257
PALMETTO GBA
UT
01
—
107006212101
IHC HEALTHPLANS
UT
01
—
4081
DMBA
UT
01
—
6603
PEHP
UT
01
—
870281028DO1
EMIA
UT
01
—
QM0000037164
ALTIUS
UT
Enumeration date
05/04/2006
Last updated
01/19/2026
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