Healthcare Provider Details

I. General information

NPI: 1932195682
Provider Name (Legal Business Name): BEAR RIVER MEDICAL ARTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 1400 S
GARLAND UT
84312-9393
US

IV. Provider business mailing address

300 W 1400 S
GARLAND UT
84312-9393
US

V. Phone/Fax

Practice location:
  • Phone: 435-257-2469
  • Fax: 435-257-2434
Mailing address:
  • Phone: 435-257-2469
  • Fax: 435-257-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2892981205
License Number StateUT

VIII. Authorized Official

Name: JAN-ERIK SCHOW
Title or Position: OWNER
Credential: MD
Phone: 435-257-2469