Individual
EDWARD W GANELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1160 E 3900 S, SUITE 2000, SALT LAKE CITY, UT 84124-1202
(801) 266-3418
(801) 288-4444
Mailing address
1160 E 3900 S, SUITE 2000, SALT LAKE CITY, UT 84124-1202
(801) 266-3418
(801) 288-4444
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
187176-1205
UT
207RI0011X
Interventional Cardiology Physician
Primary
187176-1205
UT
Other
Enumeration date
08/17/2005
Last updated
01/20/2015
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