Individual
MANASA GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124-1300
(801) 268-7111
Mailing address
PO BOX 3690, SALT LAKE CITY, UT 84110-3690
(801) 727-2059
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9550441-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2014
Last updated
06/12/2019
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