Healthcare Provider Details

I. General information

NPI: 1881816064
Provider Name (Legal Business Name): SEAN A ENKIRI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTHPARK DR
LITTLETON CO
80120-5654
US

IV. Provider business mailing address

1000 SOUTHPARK DR
LITTLETON CO
80120-5654
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-1065
  • Fax: 303-733-1699
Mailing address:
  • Phone: 303-744-1065
  • Fax: 303-733-1699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number53967
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberDR.0053967
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: