Individual
DR. PHANINDRA ANTHARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
395 W BULLDOG BLVD, PROVO, UT 84604-3311
(801) 357-7081
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
14195116-1205
UT
Other
Enumeration date
07/07/2018
Last updated
04/08/2026
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