Healthcare Provider Details

I. General information

NPI: 1427265420
Provider Name (Legal Business Name): UNIVERSITY OF UTAH HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E
SALT LAKE CITY UT
84132-2305
US

IV. Provider business mailing address

40 S 900 E
SALT LAKE CITY UT
84102-1301
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-6387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number5761148-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number5761148-8905
License Number StateUT

VIII. Authorized Official

Name: DR. MOHAMMAD SHOARI
Title or Position: M.D.
Credential: M.D.
Phone: 801-585-6387