Individual provider · Type 1 NPI
Dustin John Fanciullo, MD
Vascular Surgery Physician · Salt Lake City, UT
NPI number
1013164052
Active
Practice location
1160 E 3900 S Ste 3100
Salt Lake City, UT 84124-1290
Mailing address
PO Box 281490
Atlanta, GA 30384-1490
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgery Physician | 208600000X | 14267138-1205 (UT) |
| Vascular Surgery Physician Primary | 2086S0129X | 14267138-1205 (UT) |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
3 other providers at this address
Other vascular surgery physician providers in Salt Lake City
- Alexander SchurmanVascular Surgery Physician Salt Lake City, UT NPI 1013476258
- Kaohinani Joseph Longwolf, MDVascular Surgery Physician Salt Lake City, UT NPI 1023468238
- Daniel V. Kinikini, MDVascular Surgery Physician Salt Lake City, UT NPI 1043264070
- Ian Schlieder, DOVascular Surgery Physician Salt Lake City, UT NPI 1073956793
- Steven Charles Simper, MDVascular Surgery Physician Salt Lake City, UT NPI 1174617336
- Luke H. Degraaff, MDVascular Surgery Physician Salt Lake City, UT NPI 1205457009
- Grant Bryan EricksonVascular Surgery Physician Salt Lake City, UT NPI 1235398645
- Laura Wolf, MDVascular Surgery Physician Salt Lake City, UT NPI 1326605213
About NPI 1013164052
Dustin John Fanciullo, MD's National Provider Identifier is 1013164052, issued on Aug 21, 2008. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Salt Lake City, UT. The record was last updated on Mar 2, 2026.