Provider Demographics
NPI:1932274834
Name:MASUD, SALMAN (MD)
Entity type:Individual
Prefix:
First Name:SALMAN
Middle Name:
Last Name:MASUD
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 1:1900 JEREMY DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-2169
Mailing Address - Country:US
Mailing Address - Phone:801-424-0196
Mailing Address - Fax:
Practice Address - Street 1:1340 E. 300 N.
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-4399
Practice Address - Country:US
Practice Address - Phone:801-536-3600
Practice Address - Fax:801-536-3868
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT309097-1205207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology