Provider Demographics
NPI:1336567270
Name:TSUHA, SANEFUMI (MD)
Entity type:Individual
Prefix:
First Name:SANEFUMI
Middle Name:
Last Name:TSUHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N 1900 E
Mailing Address - Street 2:ROOM 4B319
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132
Mailing Address - Country:US
Mailing Address - Phone:801-581-8812
Mailing Address - Fax:319-356-4600
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:ROOM 4B319
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-1009
Practice Address - Country:US
Practice Address - Phone:319-356-7740
Practice Address - Fax:319-356-4600
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2015-10-20
Deactivation Date:2014-09-24
Deactivation Code:
Reactivation Date:2015-06-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program