MEDICARE: DR. VARSHA R PATHAK MD

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
1	207RN0300X	Nephrology Physician	MD451560	PA
2	207RN0300X	Nephrology Physician	DR.0059541	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	DR.0059541	OTHER	CO	CO LICENSE

General Provider Information

NPI Number	:	1568621142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VARSHA R PATHAK MD

Provider Business Mailing Address
First Line	:	300 BOARDWALK DR UNIT 3B
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3093
Country	:	US
Telephone Number	:	970-212-5367
Fax Number	:	970-212-5435

Provider Business Practice Location Address
First Line	:	300 BOARDWALK DR UNIT 3B
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3093
Country	:	US
Telephone Number	:	970-212-5367
Fax Number	:	970-212-5435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	11/27/2025

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Directions to “ DR. VARSHA R PATHAK MD” Practice Location

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