OrganizationActive
Genesis Vascular of Salt Lake
NPI 1104361591 · Interventional Cardiology Physician · Salt Lake City, UT
Provider details
- NPI number
- 1104361591
- Entity type
- Organization
- Primary specialty
- Interventional Cardiology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Genesis Vascular of Salt Lake
- Organization subpart
- Yes
- Authorized official
- Dennis Munford, Manager(385) 388-8003
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Vascular Surgery Physician2086S0129X
Allopathic & Osteopathic Physicians
Practice location
6321 S Redwood Rd
Suite 102
Salt Lake City, UT 84123-6798
Phone: (385) 388-8003
Fax: (385) 344-4006
Approximate (ZIP-level) locationGet directions
Mailing address
6321 S Redwood Rd Ste 102
Taylorsville, UT 84123-6799
Other names (DBA / former)
- Doing business as
- Genesis Vascular of Salt Lake, LLC
- Doing business as
- Genesis Vascular of Salt Lake, LLC
Registry dates
- Enumerated
- 2016-12-21
- Last updated
- 2020-10-07
- Certified
- 2020-10-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.