Provider Demographics
NPI:1861812885
Name:PAU, DHAVAL (MD)
Entity type:Individual
Prefix:DR
First Name:DHAVAL
Middle Name:
Last Name:PAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5653 S BAMBURGH VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2035
Mailing Address - Country:US
Mailing Address - Phone:618-641-7017
Mailing Address - Fax:
Practice Address - Street 1:175 N MEDICAL DRIVE EAST UNIVERSITY OF UTAH
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-2602
Practice Address - Country:US
Practice Address - Phone:801-581-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ65846207RC0200X, 2084A2900X
UT1376570612352084A2900X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care