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NPI 1134547623 · Cardiovascular Disease Physician · Salt Lake City, UT
Provider details
- NPI number
- 1134547623
- Entity type
- Individual
- Primary specialty
- Cardiovascular Disease PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- 9529232-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
30 N 1900 E Rm 4c116
University of Utah Department of Medicine Office of Edu
Salt Lake City, UT 84132-0002
Phone: (801) 585-0418
Approximate (ZIP-level) locationGet directions
Mailing address
30 N 1900 E Rm 4c116
Salt Lake City, UT 84132-0002
Registry dates
- Enumerated
- 2014-04-01
- Last updated
- 2021-10-19
- Certified
- 2021-10-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.