Healthcare Provider Details
I. General information
NPI: 1174485296
Provider Name (Legal Business Name): PROHEALTH ONE PODIATRY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8181 E TUFTS AVE STE 510
DENVER CO
80237-2580
US
IV. Provider business mailing address
8181 E TUFTS AVE STE 510
DENVER CO
80237-2580
US
V. Phone/Fax
- Phone: 720-833-7715
- Fax:
- Phone: 720-833-7715
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PRADEEP
RAI
Title or Position: OWNER
Credential: MD
Phone: 646-713-6033