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Individual

DR. ASHWIN KUMAR REDDY GANTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
3351 EASTBROOK DR STE 100, FORT COLLINS, CO 80525-5744
(970) 493-7733
(970) 493-8745
Mailing address
1600 SPECHT POINT RD, SUITE 127, FORT COLLINS, CO 80525-4311
(970) 493-7733
(970) 493-8745

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
069195
GA
207RN0300X
Nephrology Physician
Primary
DR0056836
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33970050
CO
01
DR0056836
STATE LICENSE
CO
Enumeration date
10/08/2008
Last updated
03/26/2024
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