Provider Demographics
NPI:1154595171
Name:SHUKLA, SALIL (MD)
Entity type:Individual
Prefix:
First Name:SALIL
Middle Name:
Last Name:SHUKLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8101 E LOWRY BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7195
Mailing Address - Country:US
Mailing Address - Phone:303-261-1600
Mailing Address - Fax:303-261-1601
Practice Address - Street 1:400 INDIANA ST STE 310
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5033
Practice Address - Country:US
Practice Address - Phone:303-261-1600
Practice Address - Fax:303-261-1601
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0049167207W00000X
CO49167207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10287566Medicaid
MO621463001Medicaid
TN9683902OtherCIGNA
AR1154595171OtherBLUE CROSS BLUE SHIELD
TN621463001OtherUHC
TN4191705OtherBLUE CROSS BLUE SHIELD
MS08673390Medicaid
TN9366171OtherAETNA
AR1154595171OtherBLUE CROSS BLUE SHIELD
MS08673390Medicaid
TN3001641Medicaid