Basic Information
Provider Information
NPI: 1811100449
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QALBANI
FirstName: ADNAN
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1873 S BELLAIRE ST
Address2: SUITE 420
City: DENVER
State: CO
PostalCode: 802224358
CountryCode: US
TelephoneNumber: 3037531191
FaxNumber: 3037536636
Practice Location
Address1: 8300 W 38TH AVE
Address2:  
City: WHEAT RIDGE
State: CO
PostalCode: 800336005
CountryCode: US
TelephoneNumber: 3034252015
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 10/04/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X6068SDY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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