Provider Demographics
NPI:1205813045
Name:FLEISHMAN, MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:FLEISHMAN
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 1:501 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2702
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE251712085R0202X
KS04-364822085R0202X
HIMD175462085R0202X
CO360732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01360734Medicaid
WY1205813045Medicaid
AL009981095Medicaid
MI104686122Medicaid
NC7616905Medicaid
NM95425764Medicaid
NY02300154Medicaid
IN1205813045Medicaid
MO204035901Medicaid
CAXPY201229Medicaid
NE10025709000Medicaid
KS200418240AMedicaid
IL1205813045Medicaid
NE84-059792913Medicaid
SCQ36073Medicaid
HI0000341479OtherHMSA ALL PRODUCTS
MT1205813045Medicaid
ID807434700Medicaid
IA1205813045Medicaid
UT1679513196Medicaid
AZ919772Medicaid
GA947491205AMedicaid
COCO305114Medicare PIN
HIH104902Medicare PIN
NENA1215039Medicare PIN
COG32702Medicare UPIN
NE10025709000Medicaid
SCQ36073Medicaid
NC7616905Medicaid
COC211798Medicare PIN
NENA2517037Medicare PIN
CO300089942Medicare PIN
KS200418240AMedicaid
MO204035901Medicaid
AZ919772Medicaid
NE84-059792913Medicaid
NY02300154Medicaid
MI104686122Medicaid
MT1205813045Medicaid
WY1205813045Medicaid