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BALAJI SRINIVAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1311 N MILDRED RD, CORTEZ, CO 81321-2231
(970) 565-6666
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0065561
CO
207P00000X
Emergency Medicine Physician
MD468700
PA
207P00000X
Emergency Medicine Physician
MT214066
PA

Other

Enumeration date
06/10/2017
Last updated
04/06/2022
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