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Individual

MRS. MADHURI BOBBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1200 CARSON AVE STE 103, LA JUNTA, CO 81050-2700
(719) 383-5925
(719) 383-5928
Mailing address
1200 CARSON AVE STE 103, LA JUNTA, CO 81050-2700
(719) 383-5925
(719) 383-5928

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR44733
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03171027
CO
01
BO678330
BLUE CROSS
CO
01
P00370636
RAILROAD MEDICARE
CO
Enumeration date
08/01/2006
Last updated
04/18/2008
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