Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. EDWARD ROBERT WASSMAN JR., M.D.
Active Sole ProprietorDR. EDWARD ROBERT WASSMAN JR., M.D. is a 207SG0203X healthcare provider located in PARK CITY, Utah. NPI 1396966735 is currently active in the NPPES registry. Verify at CMS.
207SG0203X · PARK CITY, UT
Registration Details
- NPI Number
- 1396966735
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 2, 2007 (19.098407649572 yrs)
- Last Updated
- Aug 10, 2022
- Licenses
-
135000 (NY)DRNM10 (CA)G040633 (CA)41719 (CT)ME80666 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7482 PINEBROOK RDPARK CITY, UT, 840985346Browse UT providers · Browse ZIP 84098
- Phone
- 5625005197
- Primary Specialty
-
207SG0203X
207SG0203X
- Additional Specialty
- Thoracic Surgery
- Additional Specialty
- Geriatric Psychiatry
- Additional Specialty
- Geriatric Psychiatry
- Additional Specialty
- Geriatric Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.