Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | DR.0054622 | CO |
Y | 208200000X | Surgeon | 003499 | GA |
Y | 208600000X | Surgeon | 003499 | GA |
N | 208200000X | Surgeon | DR.0054622 | CO |
N | 208600000X | Surgeon | DR.0054622 | CO |
NPI | 1184863631 |
---|---|
Provider Name | Dr. Pradeep Rai |
First Address | Denver, CO 80206-1116 |
Second Address | Denver, CO 80206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2009 |
Last Update Date | 16/09/2021 |