Healthcare Provider Details

I. General information

NPI: 1568082014
Provider Name (Legal Business Name): SAI SRUTHI REDDY KONDURU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SRUTHI KONDURU

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 20TH AVE
DENVER CO
80205-5422
US

IV. Provider business mailing address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberDR.0073360
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDR.0073360
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: