Healthcare Provider Details

I. General information

NPI: 1730158957
Provider Name (Legal Business Name): MARK G. FLAMMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MEDICAL DR STE 110
BOUNTIFUL UT
84010-4968
US

IV. Provider business mailing address

144 S 500 E 2ND FLOOR
SALT LAKE CITY UT
84102-1907
US

V. Phone/Fax

Practice location:
  • Phone: 801-397-0890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number149717-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number182343-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number182343-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: