Provider Demographics
NPI:1083888457
Name:UTAH SPINE MEDICINE PC
Entity Type:Organization
Organization Name:UTAH SPINE MEDICINE PC
Other - Org Name:FAISEL M, ZAMAN, M.D,, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-259-8637
Mailing Address - Street 1:5770 S 250 E STE 235
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6191
Mailing Address - Country:US
Mailing Address - Phone:801-314-5114
Mailing Address - Fax:801-314-5111
Practice Address - Street 1:5770 S 250 E STE 235
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-6191
Practice Address - Country:US
Practice Address - Phone:801-314-5114
Practice Address - Fax:801-314-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000058170Medicare PIN