Individual
DR. GOPI KRISHNA RAJU PENMETSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UNIVERSITY HOSPITAL, 50 NORTH MEDICAL DRIVE, SALT LAKE CITY, UT 84132-0001
(801) 803-8728
Mailing address
2096 E RAINBOW POINT DR, HOLLADAY, UT 84124-1721
(801) 803-8728
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
7478485-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622596
UNIVERSITY ID
—
Enumeration date
02/10/2009
Last updated
06/08/2022
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