Provider Demographics
NPI:1245627546
Name:JEWANI, SANDEEP KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:KUMAR
Last Name:JEWANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S HARRISON ST APT 209
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3379
Mailing Address - Country:US
Mailing Address - Phone:810-488-6689
Mailing Address - Fax:
Practice Address - Street 1:4003 KRESGE WAY STE 312
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-899-7377
Practice Address - Fax:502-899-1972
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036148142207R00000X, 208M00000X
KY58035207RC0200X, 207RP1001X
COCDR.0001491207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist