Provider Demographics
NPI:1457364366
Name:BAZAZ, RAJESH (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:BAZAZ
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 1:1830 FRANKLIN ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1128
Mailing Address - Country:US
Mailing Address - Phone:303-321-1333
Mailing Address - Fax:303-321-0620
Practice Address - Street 1:1830 FRANKLIN ST
Practice Address - Street 2:SUITE 450
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1128
Practice Address - Country:US
Practice Address - Phone:303-321-1333
Practice Address - Fax:303-321-0620
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42679207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32483066Medicaid
COP00141947OtherRR MEDICARE PIN
KS200423820AMedicaid
KSP00369507OtherRR MEDICARE PIN
H91838Medicare UPIN
KS200423820AMedicaid
CO544098Medicare PIN