Healthcare Provider Details

I. General information

NPI: 1396390316
Provider Name (Legal Business Name): AMERICAN HEART AND VASCULAR INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 S FASHION BLVD STE 120
MURRAY UT
84107-8115
US

IV. Provider business mailing address

3883 S KOMENDA CT
SALT LAKE CTY UT
84124-1553
US

V. Phone/Fax

Practice location:
  • Phone: 801-261-1391
  • Fax: 801-261-1394
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SOHAIL KHAN
Title or Position: OWNER
Credential: MD
Phone: 801-556-7745