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NPI Code Detail

MEDICARE: MATTHEW J. SIEBERT MD

MEDICARE: MATTHEW J. SIEBERT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician12420113-1205UT
2207XP3100XPediatric Orthopaedic Surgery Physician12420113-1205UT

General Provider Information

NPI Number : 1073141768
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW J. SIEBERT MD
Provider Business Mailing Address
First Line : 590 S WAKARA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1200
Country : US
Telephone Number : 801-587-5448
Fax Number : 801-587-5411
Provider Business Practice Location Address
First Line : 590 S WAKARA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1200
Country : US
Telephone Number : 801-587-5448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2020
Last Update Date : 06/23/2026

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