Provider Demographics
NPI:1003887738
Name:GREOS, LEON SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:SAMUEL
Last Name:GREOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:125 RAMPART WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6429
Mailing Address - Country:US
Mailing Address - Phone:720-858-7550
Mailing Address - Fax:720-858-7615
Practice Address - Street 1:13111 E BRIARWOOD AVE STE 340
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3913
Practice Address - Country:US
Practice Address - Phone:303-632-3694
Practice Address - Fax:303-632-3692
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0028923207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01289230Medicaid
COC18674Medicare PIN
CO01289230Medicaid