| Intermountain Medical Group Denver, Llc | |
|
12905 W 40th Ave, Ste 440 Wheat Ridge CO 80401 | |
| (303) 265-5780 | |
| Not Available |
| Full Name | Intermountain Medical Group Denver, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 12905 W 40th Ave, Ste 440, Wheat Ridge, Colorado |
| Authorized Official Name and Position | Jon Mcdaniel (VP FINANCE) |
| Authorized Official Contact | 3032720231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Medical Group Denver, Llc 500 Eldorado Blvd Ste 4300 Broomfield CO 80021-3564 Ph: (303) 272-0566 | Intermountain Medical Group Denver, Llc 12905 W 40th Ave, Ste 440 Wheat Ridge CO 80401 Ph: (303) 265-5780 |
| NPI Number | 1821835158 |
|---|---|
| Provider Enumeration Date | 07/12/2024 |
| Last Update Date | 07/12/2024 |
| Certification Date | 07/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821835158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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