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Contact Information

MARK SEDERBERG, DO
590 S WAKARA WAY
SALT LAKE CITY, UT84108-1200
 Phone: 801-587-5400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for MARK SEDERBERG · (Male)

NPI # 1255793576
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/25/2016
Last updated 06/11/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 11741897-1204
Hospital affiliation(s)
  • JORDAN VALLEY MEDICAL CENTER - (Acute Care)
    3580 WEST 9000 SOUTH
    WEST JORDAN, UT 84088
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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