Healthcare Provider Details

I. General information

NPI: 1326525130
Provider Name (Legal Business Name): QUSSAY MARASHLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E RM 4C116
SALT LAKE CITY UT
84132-0002
US

IV. Provider business mailing address

30 N 1900 E RM 4C116
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-7606
  • Fax:
Mailing address:
  • Phone: 801-581-7606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number349511
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: