Individual
MANA KEIHANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
74 E KIMBALLS LN STE 330, DRAPER, UT 84020-5006
(801) 266-3418
(801) 266-4174
Mailing address
PO BOX 741729, ATLANTA, GA 30374-1729
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11488535-1205
UT
207RC0000X
Cardiovascular Disease Physician
44433
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108652
—
OH
05
—
7100310290
—
KY
01
—
P01386215
RR MEDICARE
KY
Enumeration date
01/10/2011
Last updated
11/02/2023
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