Provider Demographics
NPI:1407101629
Name:AHN, JUSTIN SULKI (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:SULKI
Last Name:AHN
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 1:15 S CLARKSON ST
Mailing Address - Street 2:APT 411
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2148
Mailing Address - Country:US
Mailing Address - Phone:720-495-9980
Mailing Address - Fax:
Practice Address - Street 1:660 BANNOCK ST
Practice Address - Street 2:ROOM 395
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4506
Practice Address - Country:US
Practice Address - Phone:720-495-9980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL-4294207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine