Provider Demographics
NPI:1831406461
Name:TRIPATHI, TEJAS B (MD)
Entity type:Individual
Prefix:
First Name:TEJAS
Middle Name:B
Last Name:TRIPATHI
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 1:2400 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723-1640
Mailing Address - Country:US
Mailing Address - Phone:970-842-6262
Mailing Address - Fax:
Practice Address - Street 1:8550 W 38TH AVE STE 220
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4342
Practice Address - Country:US
Practice Address - Phone:303-403-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0052701207Q00000X
MI4301096250207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine