Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 41815 | CO |
NPI | 1528072840 |
---|---|
Provider Name | Raj Paul Wadwa |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 13/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30203511 | (05) | CO |