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NPI Code Detail

MEDICARE: TERRY SAWCHUK M.D.

MEDICARE: TERRY SAWCHUK M.D.
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
1208100000XPhysical Medicine & Rehabilitation Physician182275-1205UT

General Provider Information

NPI Number : 1164481008
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY SAWCHUK M.D.
Provider Business Mailing Address
First Line : 5770 SOUTH 250 EAST
Second Line : SUITE 135
City : SALT LAKE CITY
State : UT
Zip : 84107-8241
Country : US
Telephone Number : 801-314-2225
Fax Number : 801-314-2345
Provider Business Practice Location Address
First Line : 5770 SOUTH 250 EAST
Second Line : SUITE 135
City : SALT LAKE CITY
State : UT
Zip : 84107-8241
Country : US
Telephone Number : 801-314-2225
Fax Number : 801-314-2345
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 11/01/2022

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