Provider Demographics
NPI:1316577323
Name:MEDICAL MAN CAVE PLLC
Entity Type:Organization
Organization Name:MEDICAL MAN CAVE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CYRUS
Authorized Official - Last Name:MOTARJEME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-722-4636
Mailing Address - Street 1:250 STEELE STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5242
Mailing Address - Country:US
Mailing Address - Phone:303-722-4636
Mailing Address - Fax:303-955-8940
Practice Address - Street 1:250 STEELE STREET
Practice Address - Street 2:SUITE 350
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5242
Practice Address - Country:US
Practice Address - Phone:303-722-4636
Practice Address - Fax:303-955-8940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty