Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 26181 | CO |
NPI | 1003950700 |
---|---|
Provider Name | Dr. Rochelle Ravishankara |
First Address | Denver, CO 80247-1314 |
Second Address | Denver, CO 80218-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003697 | KAISER-COMMERCIAL NUMBER (01) | |
59380080 | (05) | CO |
D30569 | (02) | CO |