Individual
NISHEDH GYAWALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4000
Mailing address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR.0069033
CO
390200000X
Student in an Organized Health Care Education/Training Program
280071
MA
Other
Enumeration date
07/24/2019
Last updated
05/15/2025
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