Healthcare Provider Details

I. General information

NPI: 1043276033
Provider Name (Legal Business Name): ROBIN GAY MAINWARING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 E 4500 S SUITE 200
SALT LAKE CITY UT
84107-3906
US

IV. Provider business mailing address

2965 W 3500 S
WEST VALLEY CITY UT
84119-3602
US

V. Phone/Fax

Practice location:
  • Phone: 801-268-8222
  • Fax: 801-268-9926
Mailing address:
  • Phone: 801-965-3505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number183551-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number183551-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: