Healthcare Provider Details

I. General information

NPI: 1124062427
Provider Name (Legal Business Name): SUKHJINDER KHERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

IV. Provider business mailing address

2500 S HAVANA ST
AURORA CO
80014-1618
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone: 303-338-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number040556
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number42379
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number42379
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: