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Individual

MARJAN SEDIGHA BOLOURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-37113
KS
2085R0202X
Diagnostic Radiology Physician
17588
HI
2085R0202X
Diagnostic Radiology Physician
27754
NE
2085R0202X
Diagnostic Radiology Physician
Primary
53503
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000343871
HMSA ALL PRODUCTS
HI
05
10025709000
NE
05
10026277300
NE
05
10026277400
NE
05
10026277500
NE
05
10026277600
NE
05
1002627770
NE
05
10026277800
NE
05
1790930535
IA
05
1790930535
MT
05
1790930535
UT
05
1790930535
WY
05
200545800A
OK
05
201098850A
KS
05
47184841
CO
05
92403328
NM
05
935836
AZ
Enumeration date
11/20/2008
Last updated
12/07/2022
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