Provider Demographics
NPI:1215045133
Name:PARKER, ANDREW W (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:PARKER
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 1:4700 E.HALE PKWY
Mailing Address - Street 2:STE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4053
Mailing Address - Country:US
Mailing Address - Phone:303-321-6600
Mailing Address - Fax:
Practice Address - Street 1:4700 E.HALE PKWY
Practice Address - Street 2:STE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4053
Practice Address - Country:US
Practice Address - Phone:303-321-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31796207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01317965Medicaid
COE83678Medicare UPIN
COC379058Medicare PIN