Individual
SIDARTH DASARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2750 BROADWAY ST, BOULDER, CO 80304-3586
(303) 440-3000
Mailing address
2750 BROADWAY ST, BOULDER, CO 80304-3586
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
042-0015282
VT
2084N0400X
Neurology Physician
311231
NY
2084N0400X
Neurology Physician
Primary
DR.0068451
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2017
Last updated
07/25/2022
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