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MARK SEDERBERG D.O. NPI 1255793576


NPI Information

NPI: 1255793576
Provider Name: MARK SEDERBERG, D.O.
Classification: Physical Medicine & Rehabilitation - 2081S0010X
Entity Type: Individual

Specialization: Sports Medicine

Organization: SPORTSMED ASSOCIATES LLC

PECOS Registration: Yes

Address:
590 S WAKARA WAY
SALT LAKE CITY, UT
ZIP 84108
Phone: (801) 587-5400
Get Directions

Mark Sederberg, D.O. is a sports medicine physical medicine rehabilitation in Salt Lake City, UT with 8 years of experience. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. Mark Sederberg, D.O. NPI is 1255793576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2016

The provider's business location address is:

590 S WAKARA WAY
SALT LAKE CITY, UT
ZIP 84108-200
Phone: (801) 587-5400

The NPI 1255793576 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/25/2016 and was last updated on 6/11/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208100000XPhysical Medicine & Rehabilitation11741897-1204UTAHNo
22081S0010XPhysical Medicine & RehabilitationSports Medicine11741897-1204UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.