Provider Demographics
NPI:1043308380
Name:HODA, DAANISH (MD)
Entity Type:Individual
Prefix:
First Name:DAANISH
Middle Name:
Last Name:HODA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TH AVE AND C ST
Mailing Address - Street 2:LDS HOSPITAL, EAST 8 - BMT
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84143-0001
Mailing Address - Country:US
Mailing Address - Phone:801-408-1819
Mailing Address - Fax:
Practice Address - Street 1:8 TH AVE AND C ST
Practice Address - Street 2:LDS HOSPITAL, EAST 8 - BMT
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84143-0001
Practice Address - Country:US
Practice Address - Phone:801-408-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96532207R00000X
UT7351825-1205207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276791100Medicaid
FL68993OtherBLUE CROSS BLUE SHIELD
FL276791100Medicaid
FLH89655Medicare UPIN