Provider Demographics
NPI:1003804931
Name:BURGESS, ALAN W (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:W
Last Name:BURGESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-534-9550
Mailing Address - Fax:720-932-7805
Practice Address - Street 1:1601 E 19TH AVE STE 6000
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1293
Practice Address - Country:US
Practice Address - Phone:303-861-7001
Practice Address - Fax:303-861-8624
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2019-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO22232207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01222322Medicaid
COC811743Medicare PIN
COD24056Medicare UPIN
COC811608Medicare PIN
CO01222322Medicaid
CO348318Medicare PIN