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NPI Code Detail

MEDICARE: DR. KAMLEH HUSAM SHABAN M.D.

MEDICARE: DR. KAMLEH HUSAM SHABAN M.D.
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
12084P0800XPsychiatry Physician0101275560VA
22084P0804XChild & Adolescent Psychiatry Physician0101275560VA
32084P0804XChild & Adolescent Psychiatry PhysicianDR.0058437CO

General Provider Information

NPI Number : 1821356452
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAMLEH HUSAM SHABAN M.D.
Provider Business Mailing Address
First Line : 3401 QUEBEC ST STE 4500
Second Line :
City : DENVER
State : CO
Zip : 80207-2310
Country : US
Telephone Number : 720-615-8044
Fax Number :
Provider Business Practice Location Address
First Line : 3401 QUEBEC ST STE 4500
Second Line :
City : DENVER
State : CO
Zip : 80207-2310
Country : US
Telephone Number : 720-615-8044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2012
Last Update Date : 04/14/2023

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