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NPI Code Detail

MEDICARE: STEVEN GREGORY SUGDEN M.D.

MEDICARE: STEVEN GREGORY SUGDEN 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
12084A0401XAddiction Medicine (Psychiatry & Neurology) Physician280161-1205UT
22084P0800XPsychiatry PhysicianA84151CA
32084P0800XPsychiatry Physician280161-1205UT

General Provider Information

NPI Number : 1366416489
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN GREGORY SUGDEN M.D.
Provider Business Mailing Address
First Line : PO BOX 30180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84130-0180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 501 S CHIPETA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1222
Country : US
Telephone Number : 916-412-2201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 04/24/2026

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