1306170378 NPI number — DR. ANIRUDDHA VILAS WARGANTIWAR

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306170378 NPI number — DR. ANIRUDDHA VILAS WARGANTIWAR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARGANTIWAR
Provider First Name:
ANIRUDDHA
Provider Middle Name:
VILAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
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:
1306170378
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13001 E 17TH PL
Provider Second Line Business Mailing Address:
UNIVERSITY OF COLORADO DENVER SCHOOL OF MEDICINE GME
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80045-2570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-724-6031
Provider Business Mailing Address Fax Number:
720-848-2157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13001 E 17TH PL
Provider Second Line Business Practice Location Address:
UNIVERSITY OF COLORADO DENVER SCHOOL OF MEDICINE GME
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045-2570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-724-6031
Provider Business Practice Location Address Fax Number:
720-848-2157
Provider Enumeration Date:
09/23/2009

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: 390200000X , with the licence number:  3341 , 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)





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