Provider Demographics
NPI:1396199246
Name:JANISCH, NIGEEN H (MD)
Entity Type:Individual
Prefix:
First Name:NIGEEN
Middle Name:H
Last Name:JANISCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIGEEN
Other - Middle Name:F
Other - Last Name:HESSAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 N 1900 E # 701
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0002
Mailing Address - Country:US
Mailing Address - Phone:801-581-7806
Mailing Address - Fax:
Practice Address - Street 1:26 N 1900 E # 701
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-581-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11732653-1205207RC0200X, 207RP1001X
NH19649208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist