1154310779 NPI number — DR. DILSHER M NAWAZ MD

Table of content: DR. DILSHER M NAWAZ MD (NPI 1154310779)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154310779 NPI number — DR. DILSHER M NAWAZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAWAZ
Provider First Name:
DILSHER
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154310779
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4900 S MONACO ST
Provider Second Line Business Mailing Address:
#210
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80237-3486
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-750-0822
Provider Business Mailing Address Fax Number:
303-750-1298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1444 S POTOMAC ST
Provider Second Line Business Practice Location Address:
#300
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80012-4508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-750-0822
Provider Business Practice Location Address Fax Number:
303-750-1298
Provider Enumeration Date:
10/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  30170 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10026280700 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026281000 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 109730000 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1982948089 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026280600 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100171300D , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026283100 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01301704 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026281200 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026280800 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com