Individual
DR. MADHUKAR S KOLLENGODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2045 N FRANKLIN ST, DENVER, CO 80205-5437
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-3339
Taxonomy
Speciality
Code
Description
License number
State
207RA0002X
Adult Congenital Heart Disease Physician
DR.0057757
CO
207RC0000X
Cardiovascular Disease Physician
Primary
DR.0057757
CO
208000000X
Pediatrics Physician
DR.0057757
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029167
KAISER COMMERCIAL NUMBER
CO
05
—
9000132172
—
CO
Enumeration date
05/05/2009
Last updated
01/25/2022
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