Provider Demographics
NPI:1851468367
Name:SWITZER, NIKKI D (MD)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:D
Last Name:SWITZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:SWITZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9350 S 150 E
Mailing Address - Street 2:SUITE150
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-2702
Mailing Address - Country:US
Mailing Address - Phone:801-350-4602
Mailing Address - Fax:801-350-4753
Practice Address - Street 1:9350 S 150 E
Practice Address - Street 2:SUITE150
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2702
Practice Address - Country:US
Practice Address - Phone:801-350-4602
Practice Address - Fax:801-350-4753
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53769351205207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005745034Medicare ID - Type Unspecified
UTF70600Medicare UPIN