Healthcare Provider Details

I. General information

NPI: 1053637991
Provider Name (Legal Business Name): SCOTT MATTHIAS HOLLINGSHAUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY HOSPITAL 50 N MEDICAL DRIVE
SALT LAKE CITY UT
84132-0001
US

IV. Provider business mailing address

30 N 1900 E ROOM 4C104
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2121
  • Fax:
Mailing address:
  • Phone: 801-581-7606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8134323-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number8134323-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: