Healthcare Provider Details

I. General information

NPI: 1538200811
Provider Name (Legal Business Name): CEDAR CITY INSTITUTE OF WOMEN'S HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W 1325 N STE 300
CEDAR CITY UT
84720-8174
US

IV. Provider business mailing address

110 W 1325 N STE 300
CEDAR CITY UT
84720-8174
US

V. Phone/Fax

Practice location:
  • Phone: 435-865-9500
  • Fax: 435-586-8995
Mailing address:
  • Phone: 435-865-9500
  • Fax: 435-586-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5033683-1205
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: STEPHEN M SANDERS
Title or Position: PRESIDENT
Credential: MD
Phone: 435-865-9500