Individual
SAMIRA BAHRAINY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
311 W 14TH ST, PUEBLO, CO 81003-2705
(719) 584-4406
Mailing address
311 W 14TH ST, PUEBLO, CO 81003-2705
(719) 584-4406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60087911
WA
207RC0000X
Cardiovascular Disease Physician
Primary
11358501-1205
UT
208M00000X
Hospitalist Physician
MD60087911
WA
390200000X
Student in an Organized Health Care Education/Training Program
DR.0063869
CO
Other
Enumeration date
09/19/2007
Last updated
03/22/2023
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