Provider Demographics
NPI:1235266289
Name:MADAN, SATISH A (MD)
Entity Type:Individual
Prefix:
First Name:SATISH
Middle Name:A
Last Name:MADAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-320-2929
Mailing Address - Fax:303-320-2767
Practice Address - Street 1:4545 E 9TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3904
Practice Address - Country:US
Practice Address - Phone:320-320-2929
Practice Address - Fax:303-320-2767
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92054510Medicaid
011592OtherKAISER-COMMERCIAL NUMBER
CO394882YL7XMedicare PIN
CO394885YM4QMedicare PIN
CO92054510Medicaid
COCK11173Medicare PIN