Provider Demographics
NPI:1508046368
Name:DHOTRE, DHEERAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:DHEERAJ
Middle Name:
Last Name:DHOTRE
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 1:2222 N NEVADA AVE
Mailing Address - Street 2:SUITE 4004
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6832
Mailing Address - Country:US
Mailing Address - Phone:719-471-7064
Mailing Address - Fax:719-776-5459
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:SUITE 4004
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6832
Practice Address - Country:US
Practice Address - Phone:719-471-7064
Practice Address - Fax:719-776-5459
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51941207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease