Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A129202 | CA |
N | 111NI0900X | Internist | A129202 | CA |
Y | 207RH0002X | Hospice and Palliative Medicine | 12229890-1205 | UT |
N | 208000000X | Pediatrician | A129202 | CA |
NPI | 1376806745 |
---|---|
Provider Name | Dr. Mark D. Sims |
First Address | Salt Lake City, UT 84132-0002 |
Second Address | Salt Lake City, UT 84132-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 26/05/2021 |