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General NPI Number Information
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NPI Number | 1376926725
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Entity Type | Individual
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Provider Name | KRUTI SHIVLAL PATEL M.D
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 1600 N GRAND AVE STE 400
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City | PUEBLO
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State | CO
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Zip | 81003-2760
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Country | US
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Telephone | 719-585-2500
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Fax | 719-543-1041
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Provider Business Mailing Address
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Address Line | PO BOX 560825
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City | DENVER
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State | CO
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Zip | 80256-0825
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Country | US
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Telephone | 719-595-7580
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Fax | 719-545-0176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301108331
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | DR.0062298
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License Number State | CO
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