Individual
DR. MUJTABA ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8 TH AVE & C ST, SALT LAKE CITY, UT 84143-0001
(801) 507-4384
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-4384
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9431515-8017
UT
208M00000X
Hospitalist Physician
Primary
9431515-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/30/2012
Last updated
04/25/2017
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