Healthcare Provider Details

I. General information

NPI: 1982158119
Provider Name (Legal Business Name): AKHILESH MAHAJAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 N NEVADA AVE STE 305
COLORADO SPRINGS CO
80907-5318
US

IV. Provider business mailing address

1725 E 19TH ST STE 200
TULSA OK
74104-5419
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-7064
  • Fax: 719-776-5459
Mailing address:
  • Phone: 918-748-8381
  • Fax: 918-403-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberCDR.0006541
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberCDR.0006541
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberCDR.0006541
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number38811
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: