Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 12869 | NV |
N | 2086S0129X | Vascular Surgeon | 6228774-8905 | UT |
NPI | 1144498163 |
---|---|
Provider Name | Faheem Akhtar |
First Address | Murray, UT 84123-5632 |
Second Address | Ogden, UT 84403-2361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2008 |
Last Update Date | 14/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FA0058873 | DEA NUMBER (01) | NV |