| Doctor Name: | DR. GHULAM M DASTGEER |
| NPI Number: | 1164610614 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD., FRCS., ABUCM. |
| License Number: | 48962 |
| Business Practice Address: | 421 N Main St Leeds, MA - 010539764 |
| Business Phone Number: | 4135844040 |
| Business Fax Number: | |
| Mailing Address: | 4674 Jasper Ln, BROOMFIELD |
| State: | CO |
| Postal Code: | 800208131 |
| Phone Number: | 3034651905 |
| Fax Number: | 3034106903 |
| NPI Enumeration Date: | 10/10/2007 |
| NPI Last Update Date: | 10/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 48962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |