Basic Information
Provider Information
NPI: 1831362151
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GANDHE
FirstName: ANUPAMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2637 MIDPOINT DR STE B
Address2:  
City: FORT COLLINS
State: CO
PostalCode: 805254408
CountryCode: US
TelephoneNumber: 9704881666
FaxNumber: 9704729381
Practice Location
Address1: 2637 MIDPOINT DR STE B
Address2:  
City: FORT COLLINS
State: CO
PostalCode: 805254408
CountryCode: US
TelephoneNumber: 5083635000
FaxNumber: 5083635430
Other Information
ProviderEnumerationDate: 04/08/2008
LastUpdateDate: 11/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XDR.0056093CON Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XDR.0056093COY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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