MEDICARE: DR. ANANT SHUKLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD2026-0092	NM
2	207PS0010X	Sports Medicine (Emergency Medicine) Physician	DR.0076363	CO

General Provider Information

NPI Number	:	1760841423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANANT SHUKLA MD

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIR # B7500
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR # B7500
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	719-526-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	03/24/2026

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