Provider Demographics
NPI:1902118714
Name:RICH, STEVEN HAROLD JR (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:HAROLD
Last Name:RICH
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 AARON DR STE B
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8138
Mailing Address - Country:US
Mailing Address - Phone:435-775-9973
Mailing Address - Fax:435-775-9885
Practice Address - Street 1:196 E 2000 N
Practice Address - Street 2:SUITE 100
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-9335
Practice Address - Country:US
Practice Address - Phone:435-882-9035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4830229-1204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics