Provider Demographics
NPI:1326070855
Name:SHRINIVAS, SONJAY B (DO)
Entity Type:Individual
Prefix:MR
First Name:SONJAY
Middle Name:B
Last Name:SHRINIVAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5776 S. TELLURIDE CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015
Mailing Address - Country:US
Mailing Address - Phone:617-504-4449
Mailing Address - Fax:508-941-6299
Practice Address - Street 1:600 17TH ST.
Practice Address - Street 2:SUITE 2883
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202
Practice Address - Country:US
Practice Address - Phone:303-493-9509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229168208M00000X
CO0065111208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110073996AMedicaid