Individual
MIR-MUSTAFA MIR-KASIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2055 N MAIN ST, TOOELE, UT 84074-9819
(801) 463-7415
Mailing address
370 E SOUTH TEMPLE STE 260, SALT LAKE CITY, UT 84111-1290
(801) 463-7415
(801) 463-7341
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
61209461205
UT
208M00000X
Hospitalist Physician
6120946-1205
UT
Other
Enumeration date
05/25/2007
Last updated
11/03/2021
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