Healthcare Provider Details

I. General information

NPI: 1669053187
Provider Name (Legal Business Name): MARIA ABIGAIL SANGALANG CEREZO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N MEDICAL DRIVE UNIVERSITY OF UTAH HEALTH
SALT LAKE CITY UT
84132-0001
US

IV. Provider business mailing address

50 N MEDICAL DRIVE UNIVERSITY OF UTAH HEALTH
SALT LAKE CITY UT
84132-0001
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-7822
  • Fax:
Mailing address:
  • Phone:
  • Fax: 617-414-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number13851382-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: