Healthcare Provider Details

I. General information

NPI: 1457521734
Provider Name (Legal Business Name): BARBARA ELIZABETH CHADWICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 CIRCLE OF HOPE DR ARUP LABORATORIES, SURGICAL PATHOLOGY DIVISION
SALT LAKE CITY UT
84112-5500
US

IV. Provider business mailing address

1950 CIRCLE OF HOPE DR ARUP LABORATORIES, SURGICAL PATHOLOGY DIVISION
SALT LAKE CITY UT
84112-5500
US

V. Phone/Fax

Practice location:
  • Phone: 801-587-4294
  • Fax:
Mailing address:
  • Phone: 801-587-4294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number6049238-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number60022114
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number6049238-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: