Provider Demographics
NPI:1689835191
Name:SHINDE, SHIVANI S (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:S
Last Name:SHINDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2761
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:303-270-2174
Practice Address - Street 1:9501 HURON STREET
Practice Address - Street 2:NAT'L JEWISH NORTHERN ONCOLOGY
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-0001
Practice Address - Country:US
Practice Address - Phone:303-650-4042
Practice Address - Fax:303-650-4046
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055146207R00000X
CO57470207RH0002X
MN106927207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COFS2557695OtherRX
COFS2557695OtherRX