Healthcare Provider Details

I. General information

NPI: 1881578052
Provider Name (Legal Business Name): MW MEDICAL PRACTICE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 MOUNTAIN RANCH DR
PARK CITY UT
84098-6178
US

IV. Provider business mailing address

6211 S HIGHLAND DR # 4210
HOLLADAY UT
84121-2125
US

V. Phone/Fax

Practice location:
  • Phone: 847-858-9982
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROWENA CHUA
Title or Position: PRESIDENT
Credential: MD
Phone: 847-858-9982