Provider Demographics
NPI:1982600870
Name:SUBBARAO, VIJAY D (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:D
Last Name:SUBBARAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11700 W 2ND PL
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1704
Mailing Address - Country:US
Mailing Address - Phone:303-595-2727
Mailing Address - Fax:303-595-2626
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:SUITE 350
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1704
Practice Address - Country:US
Practice Address - Phone:303-595-2727
Practice Address - Fax:303-595-2626
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2022-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-28814207RC0000X
CO41901207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85237370Medicaid
COG39296Medicare UPIN
CO300815Medicare PIN