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Individual

INDRANEEL MOGARALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186
Mailing address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P3554
TX
207RN0300X
Nephrology Physician
Primary
13798871-1205
UT
207RN0300X
Nephrology Physician
P3554
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1922025378
UT
Enumeration date
07/15/2006
Last updated
08/28/2024
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