Provider Demographics
NPI:1932141694
Name:BRINDHA SURESH MD PC
Entity Type:Organization
Organization Name:BRINDHA SURESH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRINDHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SURESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-766-5553
Mailing Address - Street 1:3464 S WILLOW ST
Mailing Address - Street 2:SUITE 134
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:303-755-0404
Practice Address - Street 1:14991 E HAMPDEN AVE STE 330
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3986
Practice Address - Country:US
Practice Address - Phone:303-766-5553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODB8048OtherRAILROAD MEDICARE
COSUS36130OtherBLUE SHIELD
COSUS36130OtherBLUE SHIELD