Individual
IMAD S FARRUKH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3584 W 9000 S STE 201, WEST JORDAN, UT 84088-4773
(801) 568-0202
(801) 532-0906
Mailing address
PO BOX 150173, ABS, OGDEN, UT 84415-0173
(801) 479-0601
(801) 479-4768
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
1786741205
UT
Other
Enumeration date
09/20/2006
Last updated
11/07/2007
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