Healthcare Provider Details

I. General information

NPI: 1558377317
Provider Name (Legal Business Name): SHOBAN ARUN DAVE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HEALTH PARK DR SUITE 170
LOUISVILLE CO
80027-9757
US

IV. Provider business mailing address

90 HEALTH PARK DR SUITE 170
LOUISVILLE CO
80027-9757
US

V. Phone/Fax

Practice location:
  • Phone: 303-862-3303
  • Fax: 303-862-3308
Mailing address:
  • Phone: 303-862-3303
  • Fax: 303-862-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number50487
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: