Healthcare Provider Details

I. General information

NPI: 1639199110
Provider Name (Legal Business Name): MARK G SCHWEI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 E LIVE OAK CIR
HOLLADAY UT
84117-5544
US

IV. Provider business mailing address

2870 E LIVE OAK CIR
HOLLADAY UT
84117-5544
US

V. Phone/Fax

Practice location:
  • Phone: 801-870-9746
  • Fax:
Mailing address:
  • Phone: 801-870-9746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD00035473
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number57098911205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG50823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: