Provider Demographics
NPI:1518279488
Name:ALETI, ANIL R
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:R
Last Name:ALETI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ANIL
Other - Middle Name:R
Other - Last Name:ALETI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 173862
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3862
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-945-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0052689207R00000X
IN01068709207R00000X
PAMD440628207R00000X
WY13559C208M00000X
CODR.0052689208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP01217759OtherRAILROAD MEDICARE
CO47329718Medicaid
INP00982642OtherRAILROAD MEDICARE PTAN
IN201011500Medicaid
INM400064752Medicare PIN
COP01217759OtherRAILROAD MEDICARE
INM400069606Medicare PIN
CO47329718Medicaid