Healthcare Provider Details

I. General information

NPI: 1508312380
Provider Name (Legal Business Name): MONUMENT OCCUPATIONAL MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9820 PALISADE RIDGE DR
COLORADO SPRINGS CO
80920-1490
US

IV. Provider business mailing address

1150 W. BAPTIST ROAD
MONUMENT CO
80132
US

V. Phone/Fax

Practice location:
  • Phone: 719-313-8401
  • Fax: 888-390-1539
Mailing address:
  • Phone: 719-313-8401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number46192
License Number StateCO

VIII. Authorized Official

Name: DR. ANJMUN SHARMA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 719-313-8401