Individual
DR. PAYAM TRISTANI-FIROUZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1055 N 500 W STE 111, PROVO, UT 84604-3305
(801) 374-8999
(801) 429-8063
Mailing address
1055 N 500 W ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
3496681205
UT
207ND0101X
MOHS-Micrographic Surgery Physician
3496681205
UT
207NS0135X
Procedural Dermatology Physician
3496681205
UT
Other
Enumeration date
10/06/2006
Last updated
12/20/2021
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