Basic Information
| Provider Information | |||||||||
| NPI: | 1619102829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MESHRAM | ||||||||
| FirstName: | SHEETAL | ||||||||
| MiddleName: | PANKAJ | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PILLEWAN | ||||||||
| OtherFirstName: | SHEETAL | ||||||||
| OtherMiddleName: | SURESH | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.B.B.S. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 835 E 18TH AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038254646 | ||||||||
| FaxNumber: | 3038253215 | ||||||||
| Practice Location | |||||||||
| Address1: | 835 E 18TH AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038254646 | ||||||||
| FaxNumber: | 3038253215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2009 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 51747 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 51747 | CO | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.