Provider Demographics
NPI:1245560614
Name:TSUDA, HIDEYA (MD)
Entity Type:Individual
Prefix:
First Name:HIDEYA
Middle Name:
Last Name:TSUDA
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 1:5455 LANDMARK PL
Mailing Address - Street 2:UNIT 1113
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1950
Mailing Address - Country:US
Mailing Address - Phone:303-771-5353
Mailing Address - Fax:303-771-7353
Practice Address - Street 1:5455 LANDMARK PL
Practice Address - Street 2:UNIT 1113
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1950
Practice Address - Country:US
Practice Address - Phone:303-771-5353
Practice Address - Fax:303-771-7353
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25712174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist