IndividualActive
Mark Supiano, M.D.
NPI 1083638308 · Geriatric Medicine (Internal Medicine) Physician · Salt Lake City, UT
Provider details
- NPI number
- 1083638308
- Entity type
- Individual
- Primary specialty
- Geriatric Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 5956337-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
University of Utah Healthcare
30 North 1900 East; Ab193 Som
Salt Lake City, UT 84132-0001
Phone: (801) 587-9103
Fax: (801) 585-3384
Approximate (ZIP-level) locationGet directions
Mailing address
30 N 1900 E
Salt Lake City, UT 84132-0002
Registry dates
- Enumerated
- 2006-07-27
- Last updated
- 2021-11-23
- Certified
- 2021-11-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.