Provider Demographics
NPI:1710368931
Name:FUCHITA, MIKITA (MD)
Entity Type:Individual
Prefix:
First Name:MIKITA
Middle Name:
Last Name:FUCHITA
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 1:2201 N URSULA ST
Mailing Address - Street 2:APT 315
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7441
Mailing Address - Country:US
Mailing Address - Phone:317-600-6620
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0063825207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology