Provider Demographics
NPI:1245765643
Name:BANSAL, MEENA (DO)
Entity Type:Individual
Prefix:DR
First Name:MEENA
Middle Name:
Last Name:BANSAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 S DOWNING ST STE 240
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5855
Mailing Address - Country:US
Mailing Address - Phone:720-815-7256
Mailing Address - Fax:
Practice Address - Street 1:2535 S DOWNING ST STE 240
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:303-715-7030
Practice Address - Fax:303-715-7035
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0070528207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program