Individual
MARK N. F. MASSOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBCHB
Contact information
Practice address
30 N 1900 E RM 4R312, SALT LAKE CITY, UT 84132-0002
(801) 581-8193
Mailing address
30 N 1900 E RM 4R312, SALT LAKE CITY, UT 84132-0002
(801) 581-8193
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125065612
IL
207RN0300X
Nephrology Physician
Primary
12240898-1205
UT
Other
Enumeration date
06/25/2014
Last updated
05/27/2021
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