Healthcare Provider Details

I. General information

NPI: 1992810709
Provider Name (Legal Business Name): AMIR MANZOOR ARAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 N MEDICAL DR E NEUROLOGY
SALT LAKE CITY UT
84132-0025
US

IV. Provider business mailing address

175 N MEDICAL DR
SALT LAKE CITY UT
84112-1103
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-2886
  • Fax:
Mailing address:
  • Phone: 801-585-2886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33595
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME161894
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number34399
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2023-01538
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD222347
License Number StateOR
# 6
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD61151636
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number34399
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: