Individual
INDIRA KEDLAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 N GRAND AVE STE 120, PUEBLO, CO 81003-2755
(719) 545-9292
(719) 545-9191
Mailing address
1600 N GRAND AVE STE 120, PUEBLO, CO 81003-2755
(719) 545-9292
(719) 545-9191
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44387
CO
207R00000X
Internal Medicine Physician
A067008
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33471231
—
CO
Enumeration date
12/16/2005
Last updated
02/11/2008
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