Individual
MASARRET ASHFAQ FAZILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-4384
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-4384
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5158176-1205
UT
208M00000X
Hospitalist Physician
Primary
5158176-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72847716000
—
TX
Enumeration date
03/31/2006
Last updated
07/18/2019
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