Provider Demographics
NPI:1619093804
Name:TANYA ATAGI, MD PROFESSIONAL LLC
Entity Type:Organization
Organization Name:TANYA ATAGI, MD PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-327-7300
Mailing Address - Street 1:10099 RIDGEGATE PKWY
Mailing Address - Street 2:SIUTE 430
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5531
Mailing Address - Country:US
Mailing Address - Phone:303-327-7300
Mailing Address - Fax:303-327-7304
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:SIUTE 430
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:303-327-7300
Practice Address - Fax:303-327-7304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38153208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG99598OtherUPIN