Provider Demographics
NPI:1023100062
Name:MEHTA, SAMEER KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:KUMAR
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11700 W 2ND PL
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1704
Mailing Address - Country:US
Mailing Address - Phone:303-595-2727
Mailing Address - Fax:303-595-2626
Practice Address - Street 1:4545 E 9TH AVE STE 670
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3918
Practice Address - Country:US
Practice Address - Phone:303-801-3418
Practice Address - Fax:033-206-3513
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-08-19
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Provider Licenses
StateLicense IDTaxonomies
CO46795207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO301773Medicare PIN