Provider Demographics
NPI:1578591160
Name:HUSAIN, ASIF (MD)
Entity Type:Individual
Prefix:
First Name:ASIF
Middle Name:
Last Name:HUSAIN
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 1:10403 W COLFAX AVE STE 630
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3812
Mailing Address - Country:US
Mailing Address - Phone:303-205-1090
Mailing Address - Fax:303-205-1120
Practice Address - Street 1:1300 S POTOMAC ST STE 104
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4526
Practice Address - Country:US
Practice Address - Phone:303-671-5553
Practice Address - Fax:303-671-0332
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2024-0107207RG0100X
CODR.0041837208C00000X
CO41837207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67720056Medicaid
COP00118921OtherRAILROAD MEDICARE
COP00118921OtherRAILROAD MEDICARE
COC526208Medicare ID - Type Unspecified