Healthcare Provider Details

I. General information

NPI: 1619121019
Provider Name (Legal Business Name): SANJEEV MURTHI RAMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 N 1900 E #701 WINTROBE
SALT LAKE CITY UT
84132-0002
US

IV. Provider business mailing address

26 N 1900 E #701 WINTROBE
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-7806
  • Fax: 801-585-3355
Mailing address:
  • Phone: 801-581-7806
  • Fax: 801-585-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number7334863-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number7334863-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: