Gudavalli, Sumalatha M

Gudavalli, Sumalatha M is an individual health care provider with primary practice located at 12605 E 16Th Ave , Aurora CO 80045-2545. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Gudavalli, Sumalatha M can be contacted via phone (720) 848-0000.

Contact Information

Primary practice address
12605 E 16Th Ave Aurora CO 80045-2545
Phone: (720) 848-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 1545 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA.0001545 Colorado

Profile Details

NPI number 1770610719
LBN Legal business name Gudavalli, Sumalatha M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Mar 21st, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770610719 NPPES
Colorado MEDICAID 98038214
Colorado Other 013652

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