Provider Demographics
NPI:1861075061
Name:GIRI, AJAY (MD)
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:
Last Name:GIRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4624 S HOLLADAY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-7054
Mailing Address - Country:US
Mailing Address - Phone:801-277-2682
Mailing Address - Fax:801-277-2980
Practice Address - Street 1:4624 S HOLLADAY BLVD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-7054
Practice Address - Country:US
Practice Address - Phone:801-277-2682
Practice Address - Fax:801-277-2980
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDMRM-2048207Q00000X
UT14024467-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine