Provider Demographics
NPI:1679793699
Name:LONG, SHARMINI ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:SHARMINI
Middle Name:ELIZABETH
Last Name:LONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARMINI
Other - Middle Name:ELIZABETH
Other - Last Name:APPUDORAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9695 S YOSEMITE ST STE 285
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2890
Mailing Address - Country:US
Mailing Address - Phone:303-649-3115
Mailing Address - Fax:303-649-3116
Practice Address - Street 1:9695 S YOSEMITE ST STE 285
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2890
Practice Address - Country:US
Practice Address - Phone:303-649-3115
Practice Address - Fax:303-649-3116
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0051486207R00000X
AL00027097207R00000X
CODR.0051486207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine