Provider Demographics
NPI:1144277369
Name:PAWAR, MANOJ V (MD)
Entity type:Individual
Prefix:
First Name:MANOJ
Middle Name:V
Last Name:PAWAR
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 1:6578 ESMERALDA DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9189
Mailing Address - Country:US
Mailing Address - Phone:303-596-9250
Mailing Address - Fax:
Practice Address - Street 1:6578 ESMERALDA DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-9189
Practice Address - Country:US
Practice Address - Phone:303-596-9250
Practice Address - Fax:720-727-9355
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01337971Medicaid
080115408OtherMEDICARE RAILROAD
COC166068Medicare PIN
080115408OtherMEDICARE RAILROAD