# MEDICAL RTD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912030743
- **Authorized official:** TATYANA I DATKHAEVA MD (OWNER PHYSICIAN)
- **Authorized official phone:** (720) 540-7155

## Contact information

- **Practice address:** 7615 W 38TH AVE, UNIT B-123, WHEAT RIDGE, CO 80033-6172
- **Practice address phone:** (303) 432-2776
- **Practice address fax:** (303) 432-2216
- **Mailing address:** 7615 W 38TH AVE, UNIT B-123, WHEAT RIDGE, CO 80033
- **Mailing address phone:** (720) 540-7155
- **Mailing address fax:** (720) 540-7155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 45108 | CO | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 03/07/2023