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NPI Code Detail

MEDICARE: DR. RUTH SEABROOK M.D.

MEDICARE: DR. RUTH SEABROOK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080N0001XNeonatal-Perinatal Medicine Physician14223057-8905UT
22080N0001XNeonatal-Perinatal Medicine Physician350099960OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417154709
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUTH SEABROOK M.D.
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5121 S COTTONWOOD ST
Second Line :
City : MURRAY
State : UT
Zip : 84107-5701
Country : US
Telephone Number : 801-357-7081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 03/09/2026

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