Provider Demographics
NPI:1831140011
Name:JAVAID, FAISAL
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:
Last Name:JAVAID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2422
Mailing Address - Fax:970-490-4173
Practice Address - Street 1:7000 E BELLEVIEW AVE STE 209
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1622
Practice Address - Country:US
Practice Address - Phone:720-482-3777
Practice Address - Fax:720-482-3776
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0070204207R00000X
PAMD463883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS104674OtherBLUE SHIELD
KS200331460AMedicaid
KS928164OtherFIRST GUARD
KS200331460AMedicaid
KS104674OtherBLUE SHIELD