MEDICARE: MR. DOUGLAS MARR WOSETH 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
1	207N00000X	Dermatology Physician	A79309	CA
2	174400000X	Specialist	6144238	UT

General Provider Information

NPI Number	:	1619978970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DOUGLAS MARR WOSETH M.D.

Provider Business Mailing Address
First Line	:	1548 EAST 4500 SOUTH,
Second Line	:	SUITE 202
City	:	SALT LAKE
State	:	UT
Zip	:	84117-5209
Country	:	US
Telephone Number	:	801-266-8841
Fax Number	:	801-266-0449

Provider Business Practice Location Address
First Line	:	1548 EAST 4500 SOUTH,
Second Line	:	SUITE 202
City	:	SALT LAKE
State	:	UT
Zip	:	84117-5209
Country	:	US
Telephone Number	:	801-266-8841
Fax Number	:	801-266-0449

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/09/2014

Similar Medicare Providers

1891700498 — K AND A HOLDINGS
Practice Location Address:

4658 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-277-2696
Practice Fax:

1184846131 — DR. ADAM M BOWMAN MD
Practice Location Address:

1548 E 4500 S STE 105
SALT LAKE CITY, UT
84117-5209

Practice Phone: 14-243-0908
Practice Fax: 801-424-3091

1639348899 — STACY RUTH SMITH M.D.
Practice Location Address:

1548 E 4500 S STE 105
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-424-3090
Practice Fax: 801-424-3091

1710242235 — DR. BRETON ADAM OREL YATES M.D.
Practice Location Address:

1548 E 4500 S , STE 202
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-679-4600
Practice Fax:

1538577655 — SALT LAKE PEDIATRIC DENTISTRY
Practice Location Address:

1548 E 4500 S STE 102
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-463-1900
Practice Fax:

1750150876 — CONFLUENCE COUNSELING PLLC
Practice Location Address:

1548 E 4500 S STE 201
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-252-5146
Practice Fax:

Directions to “ MR. DOUGLAS MARR WOSETH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.