Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 6266 | GA |
Y | 208000000X | Pediatrician | 9712506-1205 | UT |
N | 2080P0202X | Pediatric Cardiologist | 9712506-8905 | UT |
NPI | 1033558903 |
---|---|
Provider Name | Igor A Areinamo |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84105-3208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2013 |
Last Update Date | 09/05/2017 |