Individual
DR. MARYAM REZVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 NORTH 1900 EAST, #1A71, SALT LAKE CITY, UT 84132
(801) 581-8699
(801) 581-2414
Mailing address
30 N 1900 E, #1A71, SALT LAKE CITY, UT 84132-2140
(801) 581-7553
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
01060592A
IN
2085B0100X
Body Imaging Physician
036-115412
IL
2085B0100X
Body Imaging Physician
65868131205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
6586813-1205
UT
Other
Enumeration date
04/24/2007
Last updated
11/15/2021
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