Healthcare Provider Details

I. General information

NPI: 1861327926
Provider Name (Legal Business Name): SHOURYA MADHUR KADAM EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3539 HURON PEAK AVE
SUPERIOR CO
80027-6151
US

IV. Provider business mailing address

3539 HURON PEAK AVE
SUPERIOR CO
80027-6151
US

V. Phone/Fax

Practice location:
  • Phone: 720-206-6170
  • Fax:
Mailing address:
  • Phone: 720-206-6170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberQ260371
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: