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Individual

DR. HANNA K. FANOUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
30 N 1900 E RM 4A100, SALT LAKE CITY, UT 84132-0002
(801) 581-2121
Mailing address
30 N 1900 E RM 4A100, SALT LAKE CITY, UT 84132-0002
(801) 581-2121

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10070653
TX
207RC0000X
Cardiovascular Disease Physician
Primary
13296086-1205
UT

Other

Enumeration date
05/01/2020
Last updated
03/09/2023
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