DR. MARYAM REZVANI (NPI# 1770701542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770701542 |
| Entity Type | Individual |
| Full Name | DR. MARYAM REZVANI |
| Credential | M.D. |
| Practice Address |
30 North 1900 East #1a71 Salt Lake City UT 84132 |
| Mailing Address |
30 N 1900 E #1a71 Salt Lake City UT 84132-2140 |
| Practice Telephone | 8015818699 |
| Practice Fax Number | 8015812414 |
| Mailing Telephone | 8015817553 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2015-11-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
65868131205 | UT | Allopathic & Osteopathic Physicians |
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
036-115412 | IL | Allopathic & Osteopathic Physicians |
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
01060592A | IN | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
6586813-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
30 NORTH 1900 EAST #1A71 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598393910 | Vincent Huang | Student in an Organized Health Care Education/Training Program | 30 North 1900 East, Room 4c104, Salt Lake City, OH 45243 | 2020-03-31 |
| 1598298663 | Hansjorg Schwertz | Preventive Medicine | 30 North 1900 East, University of Utah School of Medicine, Internal Medicin, Salt Lake City, UT 84132 | 2017-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
| 1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
| 1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
| Find all providers in zip 84132 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296505 | Us Sports Medicine, LLC | Radiology | 1178 E Brickyard Rd, Salt Lake City, UT 84106-2555 | 2019-10-09 |
| 1467865329 | Shane Nicholas Weber | Radiology | 30 N 1900 E Rm 1a07, Salt Lake City, UT 84132-0002 | 2014-06-09 |
| 1508124843 | Nikolas Michael Damme | Radiology | 30 N 1900 East #1a071, Apt B4, Salt Lake City, UT 84413-2140 | 2012-04-24 |
| 1093071045 | Kaerli Main Christensen | Radiology | 30 North 1900 East, Room 4c104, University of Utah Department of Internal Medicine, Salt Lake City, UT 84132 | 2012-04-04 |
| 1952697849 | Ashley D. Gettemy | Radiology | 30 N 1900 E Rm 1a071, Salt Lake City, UT 84132-0002 | 2011-06-20 |
| 1598056848 | Miriam Peckham | Radiology | 30 N 1900 E # 1c412, Gme Office, Salt Lake City, UT 84132-2115 | 2011-04-20 |
| 1285945006 | David Cameron Olson | Radiology | 30 N 1900 E # 1a71, Salt Lake City, UT 84132-0002 | 2010-06-25 |
| 1619292182 | Richard Keller | Radiology | 1235 East 200 South #702, 1235 East 200 South #702, Salt Lake City, UT 84102-8410 | 2010-03-29 |
| 1699914267 | George Nicholas Baldwin | Radiology | 3519 E. Arcata R, Salt Lake City, UT 84124-4738 | 2009-02-05 |
| 1285896415 | Joseph Scott Mcnally | Radiology | 447 Edith Ave, Salt Lake City, UT 84111-4724 | 2008-06-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.