Healthcare Provider Details

I. General information

NPI: 1144431107
Provider Name (Legal Business Name): ERIC STEDMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 S 700 E
SALT LAKE CITY UT
84106-1182
US

IV. Provider business mailing address

3802 S 700 E
SALT LAKE CITY UT
84106-1182
US

V. Phone/Fax

Practice location:
  • Phone: 801-264-6000
  • Fax:
Mailing address:
  • Phone: 801-264-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number8006131-1204
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8006131-1204
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR7911
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: