=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760708507
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PRATEEK CHAUDHARY DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2010
-----------------------------------------------------
Last Update Date | 05/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3455 LUTHERAN PKWY STE 100
-----------------------------------------------------
City | WHEAT RIDGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80033-6028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-494-4700
-----------------------------------------------------
Fax | 720-494-4706
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 35380
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89133-5380
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | N4982
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number | DR0052182
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------