Provider Demographics
NPI:1568697514
Name:ANSARI, SAFDAR ABBAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SAFDAR
Middle Name:ABBAS
Last Name:ANSARI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:175 N MEDICAL DR E RM 3130
Mailing Address - Street 2:UNIVERSITY OF UTAH, CLINICAL NEUROSCIENCE CENTER
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-587-9935
Mailing Address - Fax:801-587-8039
Practice Address - Street 1:175 N MEDICAL DR E RM 3130
Practice Address - Street 2:UNIVERSITY OF UTAH, CLINICAL NEUROSCIENCE CENTER
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-587-9935
Practice Address - Fax:801-587-8039
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2021-10-16
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Provider Licenses
StateLicense IDTaxonomies
UT8017411-12052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology