Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 52607 | CO |
NPI | 1063578516 |
---|---|
Provider Name | Sonali Hemachandra |
First Address | Wheat Ridge, CO 80034-1449 |
Second Address | Wheat Ridge, CO 80033-4880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 09/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000644136 | ANTHEM (01) | IN |
200975100 | (05) | IN |
30.56240 | (05) | OH |
32825234 | (05) | CO |
P00818289 | RAILROAD MEDICARE (01) | IN |