Healthcare Provider Details

I. General information

NPI: 1922290915
Provider Name (Legal Business Name): SANDEEP TALWAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W BOURNE CIR STE 200
FARMINGTON UT
84025
US

IV. Provider business mailing address

444 W BOURNE CIR STE 200
FARMINGTON UT
84025-3657
US

V. Phone/Fax

Practice location:
  • Phone: 801-776-0174
  • Fax: 801-825-3904
Mailing address:
  • Phone: 801-397-3000
  • Fax: 801-397-0455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number036177650
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD156930
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD156930
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number7771396-1205
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number7771396-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: