Individual
SUJANA BALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
HELIX: 30 N MARIO CAPECCHI DR RM 3N100, SALT LAKE CITY, UT 84112
(801) 581-2121
Mailing address
HELIX: 30 N MARIO CAPECCHI DR RM 3N100, SALT LAKE CITY, UT 84112
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
13930758-1205
UT
Other
Enumeration date
03/24/2020
Last updated
05/06/2024
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