Provider Demographics
NPI:1760774178
Name:SHEMSHEDINI, TEUTA (MD)
Entity Type:Individual
Prefix:
First Name:TEUTA
Middle Name:
Last Name:SHEMSHEDINI
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 1:2750 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3586
Mailing Address - Country:US
Mailing Address - Phone:303-938-4710
Mailing Address - Fax:303-541-0807
Practice Address - Street 1:4745 ARAPAHOE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1082
Practice Address - Country:US
Practice Address - Phone:303-938-4750
Practice Address - Fax:303-541-0807
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD460247207V00000X
MN65437207V00000X
FLME144062207V00000X
CODR.0066051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME144062OtherFL MEDICAL LICENSE
PAMD460247OtherPA MEDICAL LICENSE