| Mayfair Internal Medicine, P.c. | |
|
6311 E 14th Ave Denver CO 80220-2821 | |
| (303) 333-6434 | |
| (303) 333-6505 |
| Full Name | Mayfair Internal Medicine, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6311 E 14th Ave, Denver, Colorado |
| Authorized Official Name and Position | Edith Sarah Lovegren (PHYSICIAN PARTNER) |
| Authorized Official Contact | 3033336434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mayfair Internal Medicine, P.c. 6311 E 14th Ave Denver CO 80220-2821 Ph: (303) 333-6434 | Mayfair Internal Medicine, P.c. 6311 E 14th Ave Denver CO 80220-2821 Ph: (303) 333-6434 |
| NPI Number | 1447466073 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 11/04/2010 |
| Medicare PECOS PAC ID | 5395637474 |
|---|---|
| Medicare Enrollment ID | O20040325000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447466073 | NPI | - | NPPES |
| 04016044 | Medicaid | CO | |
| MAC | Other | CO | GROUP BLUE CROSS BLUE SHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | David L Bolshoun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174618086 PECOS PAC ID: 3476586223 Enrollment ID: I20050913000953 |
| Provider Name | Edith S Lovegren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871688838 PECOS PAC ID: 8628263373 Enrollment ID: I20101108001462 |
| Provider Name | Larry M Plunkett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427143338 PECOS PAC ID: 6901091651 Enrollment ID: I20101108001466 |
| Provider Name | Molly Melissa Pickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518392570 PECOS PAC ID: 1850526062 Enrollment ID: I20131024000580 |
| Provider Name | Jennifer Hope Dahl-iglehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992337331 PECOS PAC ID: 6608203930 Enrollment ID: I20200227000377 |
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