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General NPI Number Information
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NPI Number | 1124206396
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Entity Type | Organization
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Legal Business Name | PRANA INTERNAL MEDICINE PLLC
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Dates
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Enumeration Date | 02/09/2008
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 3292 S BANNOCK ST
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2418
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Country | US
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Telephone | 303-761-1045
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Fax | 303-761-1253
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Provider Business Mailing Address
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Address Line | 3292 S BANNOCK ST
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2418
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Country | US
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Telephone | 303-761-1045
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Fax | 303-761-1253
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KHURRAM HUSSAIN
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Credential | MD
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Telephone | 303-761-1045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 40764
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License Number State | CO
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