Healthcare Provider Details

I. General information

NPI: 1962339200
Provider Name (Legal Business Name): ARUNITI MANAWA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 16TH ST
PUEBLO CO
81003-2745
US

IV. Provider business mailing address

400 W 16TH ST
PUEBLO CO
81003-2745
US

V. Phone/Fax

Practice location:
  • Phone: 719-584-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTL.0011590
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: