Healthcare Provider Details
I. General information
NPI: 1497078141
Provider Name (Legal Business Name): GRACE HSIEH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/09/2010
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US
IV. Provider business mailing address
3300 N TRIUMPH BLVD STE G50
LEHI UT
84043-6480
US
V. Phone/Fax
- Phone: 801-507-7000
- Fax:
- Phone: 801-990-1911
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | 12383935-1205 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 12383935-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: