Organization · Type 2 NPI

Genesis Vascular of Salt Lake

Interventional Cardiology Physician · Salt Lake City, UT

NPI number 1104361591 Active

Practice location

6321 S Redwood Rd, Suite 102
Salt Lake City, UT 84123-6798

Call (385) 388-8003 Map

Fax (385) 344-4006

Mailing address

6321 S Redwood Rd Ste 102
Taylorsville, UT 84123-6799

Specialties and licenses

Taxonomy	Code	License
Interventional Cardiology Physician Primary	207RI0011X	None listed
Vascular & Interventional Radiology Physician	2085R0204X	None listed
Vascular Surgery Physician	2086S0129X	None listed

Interventional Cardiology Physician: An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

10 other providers at this address

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NPI record

NPI: 1104361591
Entity type: Organization (Type 2)
Issued: Dec 21, 2016
Last updated: Oct 7, 2020
Status: Active
Subpart: Yes of Genesis Vascular of Salt Lake

Other names

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Genesis Vascular of Salt Lake, LLC · doing business as
Genesis Vascular of Salt Lake, LLC · doing business as

Authorized official

Dennis Munford
Manager
(385) 388-8003

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104361591

Genesis Vascular of Salt Lake's National Provider Identifier is 1104361591, issued on Dec 21, 2016. The primary taxonomy on file is Interventional Cardiology Physician (207RI0011X), and the practice location is in Salt Lake City, UT. The record was last updated on Oct 7, 2020.