Provider Demographics
NPI:1225162118
Name:STEVEN J GULEVICH MD NEUROLOGY
Entity Type:Organization
Organization Name:STEVEN J GULEVICH MD NEUROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GULEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-788-0290
Mailing Address - Street 1:3464 S WILLOW ST
Mailing Address - Street 2:SUITE 075
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:
Practice Address - Street 1:8601 W CROSS DR
Practice Address - Street 2:F5-308
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0702
Practice Address - Country:US
Practice Address - Phone:303-788-0290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04013066Medicaid
NE=========01Medicaid