Individual
SHIVANI R PATHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9960 SKY RIDGE AVE, LONE TREE, CO 80124-5644
(303) 706-1616
Mailing address
9960 SKY RIDGE AVE, LONE TREE, CO 80124-5644
(303) 706-1616
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
DR.0067168
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280986
—
CA
Enumeration date
04/13/2015
Last updated
03/01/2024
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