Healthcare Provider Details

I. General information

NPI: 1093001406
Provider Name (Legal Business Name): MUTHULAKSHMI YEGAPPAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 02/07/2024
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 W 2ND PL
LAKEWOOD CO
80228-1527
US

IV. Provider business mailing address

PO BOX 800022
KANSAS CITY MO
64180-0022
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-0000
  • Fax: 720-321-1759
Mailing address:
  • Phone: 800-953-0104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0054220
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDR.0054220
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: