| Magnolia Medical Group | |
|
1490 N Lafayette St Ste 104 Denver CO 80218-2391 | |
| (303) 209-5115 | |
| Not Available |
| Full Name | Magnolia Medical Group |
|---|---|
| Speciality | Internal Medicine - Addiction Medicine |
| Location | 1490 N Lafayette St Ste 104, Denver, Colorado |
| Authorized Official Name and Position | Pradeep Rai (DIRECTOR) |
| Authorized Official Contact | 3032095115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Medical Group 2925 E Colfax Ave Denver CO 80206-1604 Ph: (303) 209-5115 | Magnolia Medical Group 1490 N Lafayette St Ste 104 Denver CO 80218-2391 Ph: (303) 209-5115 |
| NPI Number | 1003672619 |
|---|---|
| Provider Enumeration Date | 02/22/2024 |
| Last Update Date | 02/22/2024 |
| Certification Date | 02/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003672619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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