Basic Information
Provider Information
NPI: 1457435513
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHERER
FirstName: PATRICK
MiddleName: MARK
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1575 OLD MAIL TRL
Address2:  
City: MOAB
State: UT
PostalCode: 845324012
CountryCode: US
TelephoneNumber: 4352601146
FaxNumber:  
Practice Location
Address1: 450 WILLIAMS WAY
Address2:  
City: MOAB
State: UT
PostalCode: 845322185
CountryCode: US
TelephoneNumber: 4357193500
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 03/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X277955-1204UTY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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