Provider Demographics
NPI:1427166842
Name:ISMAIL, NAVEED H (MD)
Entity type:Individual
Prefix:
First Name:NAVEED
Middle Name:H
Last Name:ISMAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 S GALENA ST STE 314
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3729
Mailing Address - Country:US
Mailing Address - Phone:303-766-0357
Mailing Address - Fax:855-296-3934
Practice Address - Street 1:6825 S GALENA ST STE 314
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3729
Practice Address - Country:US
Practice Address - Phone:303-766-0357
Practice Address - Fax:855-296-3934
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40926174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG85643Medicare UPIN
COC522538Medicare PIN