Provider Demographics
NPI:1295776664
Name:NENE, SHRIRAM M (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:SHRIRAM
Middle Name:M
Last Name:NENE
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:STE 120
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-695-1313
Mailing Address - Fax:303-695-5121
Practice Address - Street 1:1390 S POTOMAC ST
Practice Address - Street 2:STE 120
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6165
Practice Address - Country:US
Practice Address - Phone:303-695-1313
Practice Address - Fax:303-695-5121
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO40627174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG45152Medicare UPIN
COCA1808Medicare ID - Type Unspecified