Provider Demographics
NPI:1114907425
Name:REUTER, GREGORY C (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:C
Last Name:REUTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:1801 16TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105282174400000X
CO605092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100159440DMedicaid
CO663169OtherMEDICARE
KS111257117OtherMEDICARE
MO3234841AOtherRAILROAD MEDICARE- INDIV
CO663196OtherMEDICARE
KSCI2562OtherRAILROAD MEDICARE- GROUP
CO663145OtherMEDICARE
NENA2517109OtherMEDICARE
CO663203OtherMEDICARE
CO663183OtherMEDICARE
NENA1214132OtherMEDICARE
MOCI3618OtherRAILROAD MEDICARE- GROUP
NENA1215133OtherMEDICARE
KS3234841BOtherRAILROAD MEDICARE- INDIV
CO663152OtherMEDICARE
KSKA3249108OtherMEDICARE
NE$$$$$$$$$06Medicaid
CO663203OtherMEDICARE
MOCI3618OtherRAILROAD MEDICARE- GROUP
NE$$$$$$$$$04Medicaid
CO663196OtherMEDICARE
KS100159440DMedicaid