Sumalatha M Gudavalli, is a
Physician Assistant physician based in Aurora, Colorado. Sumalatha M Gudavalli is licensed to practice in Colorado (license number PA.0001545) and her current practice location is 12605 E 16th Ave, Aurora, Colorado. She can be reached at her office (for appointments etc.) via phone at
(720) 848-0000.
NPI number for Sumalatha M Gudavalli is 1770610719 and her current mailing address is Po Box 110429, Aurora, Colorado. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770610719.
Physician's Profile
| Full Name | Sumalatha M Gudavalli |
|---|
| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 12605 E 16th Ave, Aurora, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1770610719
- Provider Enumeration Date: 02/27/2007
- Last Update Date: 03/21/2016
Medical Identifiers
Medical identifiers for Sumalatha M Gudavalli such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770610719 | NPI | - | NPPES |
| 98038214 | Medicaid | CO | |
| 013652 | Other | | KAISER-COMMERCIAL NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 1545 (Colorado) | Secondary |
| 363A00000X | Physician Assistant | PA.0001545 (Colorado) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sumalatha M Gudavalli is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Sumalatha M Gudavalli,
Po Box 110429,
Aurora, CO 80042-0429
Ph: (303) 493-7000 | Sumalatha M Gudavalli,
12605 E 16th Ave,
Aurora, CO 80045-2545
Ph: (720) 848-0000 |
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