Provider Demographics
NPI:1467200790
Name:CHRIS THIAGARAJAH MD INCORPORATED
Entity type:Organization
Organization Name:CHRIS THIAGARAJAH MD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:THIAGARAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-550-1190
Mailing Address - Street 1:PO BOX 12466
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-0466
Mailing Address - Country:US
Mailing Address - Phone:720-509-9889
Mailing Address - Fax:720-528-7671
Practice Address - Street 1:1140 EDWARDS VILLAGE BLVD UNIT B206
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-5562
Practice Address - Country:US
Practice Address - Phone:720-509-9889
Practice Address - Fax:720-528-7671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty