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Individual

AMIR TEIMOURI DERESHGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
30 N MARIO CAPECCHI DR RM 4S100, SALT LAKE CITY, UT 84112
(801) 581-2121
Mailing address
30 N MARIO CAPECCHI DR RM 4S100, SALT LAKE CITY, UT 84112
(801) 581-2121

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
13613795-1205
UT

Other

Enumeration date
03/22/2022
Last updated
10/02/2023
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