Healthcare Provider Details

I. General information

NPI: 1104894252
Provider Name (Legal Business Name): ANDREA KATHLEEN SOTELO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6116 E WARREN AVE
DENVER CO
80222-5703
US

IV. Provider business mailing address

103 CONTINENTAL PL STE 400
BRENTWOOD TN
37027-1041
US

V. Phone/Fax

Practice location:
  • Phone: 303-512-0888
  • Fax: 303-512-2268
Mailing address:
  • Phone: 615-916-3200
  • Fax: 615-658-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number42674
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: