Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 7465193-1205 | UT |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 7465193-1205 | UT |
NPI | 1023261237 |
---|---|
Provider Name | Carolyn Weaver Swenson |
First Address | Salt Lake City, UT 84132-0001 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2008 |
Last Update Date | 11/01/2022 |