Individual
MOHAMED DAFALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1175 E 50 S STE 241, AMERICAN FORK, UT 84003-2849
(801) 429-8008
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12371377-1205
UT
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
12371377-1205
UT
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
12371377-1205
UT
Other
Enumeration date
03/29/2014
Last updated
01/07/2022
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