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NPI Code Detail

MEDICARE: DR. BAHAR SHAHIDI D.P.T.

MEDICARE: DR. BAHAR SHAHIDI D.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist10517CO

General Provider Information

NPI Number : 1134454309
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BAHAR SHAHIDI D.P.T.
Provider Business Mailing Address
First Line : 2911 SAINT PAUL ST
Second Line :
City : DENVER
State : CO
Zip : 80205-4835
Country : US
Telephone Number : 510-847-7769
Fax Number :
Provider Business Practice Location Address
First Line : 320 E 1ST AVE
Second Line : SUITE 102
City : BROOMFIELD
State : CO
Zip : 80020-3786
Country : US
Telephone Number : 303-460-0329
Fax Number : 303-460-0387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2009
Last Update Date : 10/06/2009

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