IndividualActive
Pavalan Panneer Selvam, MBBS
NPI 1891445169 · Clinical Genetics (M.D.) Physician · Salt Lake City, UT
Provider details
- NPI number
- 1891445169
- Entity type
- Individual
- Primary specialty
- Clinical Genetics (M.D.) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MBBS
- Sex
- Male
- Sole proprietor
- No
- License
- 13521401-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
295 S Chipeta Way Rm 2w245
Salt Lake City, UT 84108-1287
Phone: (801) 581-2121
Approximate (ZIP-level) locationGet directions
Mailing address
295 S Chipeta Way Rm 2w245
Salt Lake City, UT 84108-1287
Registry dates
- Enumerated
- 2022-03-28
- Last updated
- 2023-08-03
- Certified
- 2023-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.