Healthcare Provider Details

I. General information

NPI: 1215348222
Provider Name (Legal Business Name): SARA VATAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 E EVANS AVE STE 101
DENVER CO
80222-5320
US

IV. Provider business mailing address

4700 E ILIFF AVE
DENVER CO
80222-6025
US

V. Phone/Fax

Practice location:
  • Phone: 303-335-0062
  • Fax:
Mailing address:
  • Phone: 303-946-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD178862
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57917
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: