Provider Demographics
NPI:1942465653
Name:BHAMRA, MANDEEP SINGH (MD)
Entity Type:Individual
Prefix:
First Name:MANDEEP
Middle Name:SINGH
Last Name:BHAMRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MANDEEP
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:382 S ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-3094
Mailing Address - Country:US
Mailing Address - Phone:303-604-5000
Mailing Address - Fax:720-890-0364
Practice Address - Street 1:13952 DENVER WEST PKWY
Practice Address - Street 2:BUILDING 53 #100
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3141
Practice Address - Country:US
Practice Address - Phone:303-604-5000
Practice Address - Fax:720-890-0364
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263952-1207RG0100X
CODR.0057791207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology