Provider Demographics
NPI:1902996523
Name:SCAIFE, ERIC RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:RICHARD
Last Name:SCAIFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 413035
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84141-3035
Mailing Address - Country:US
Mailing Address - Phone:801-213-3900
Mailing Address - Fax:801-662-2980
Practice Address - Street 1:100 N MARIO CAPECCHI DR
Practice Address - Street 2:SUITE 2600
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1103
Practice Address - Country:US
Practice Address - Phone:801-662-2950
Practice Address - Fax:801-662-2980
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT31852812052086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD3824Medicaid
UTD3824Medicaid