Healthcare Provider Details

I. General information

NPI: 1710627492
Provider Name (Legal Business Name): SHIV PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 19TH AVE
DENVER CO
80218-1114
US

IV. Provider business mailing address

1375 E 19TH AVE
DENVER CO
80218-1114
US

V. Phone/Fax

Practice location:
  • Phone: 303-812-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDR.0075305
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: