Basic Information
| Provider Information | |||||||||
| NPI: | 1235348897 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASSIAGO | ||||||||
| FirstName: | MARCELLUS | ||||||||
| MiddleName: | SAKA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DIVISION OF NEPHROLOGY UNIVERSITY OF UTAH | ||||||||
| Address2: | PO BOX 413033 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841413033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012133900 | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY OF UTAH | ||||||||
| Address2: | 50 NORTH MEDICAL DRIVE | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841320100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015816709 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 13068 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 6856533-1205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.