Individual
AMAR CHAND JETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
DR45869
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13352857
—
CO
01
—
DR-45869
STATE LICENSE
CO
01
—
P00452978
RAILROAD MEDICARE
CO
Enumeration date
10/04/2007
Last updated
04/18/2008
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