Provider Demographics
NPI:1376503300
Name:DANNER, PAUL K (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:K
Last Name:DANNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2490 W 26TH AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5314
Mailing Address - Country:US
Mailing Address - Phone:303-433-9729
Mailing Address - Fax:303-480-0405
Practice Address - Street 1:2490 W 26TH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5314
Practice Address - Country:US
Practice Address - Phone:303-433-9729
Practice Address - Fax:303-480-0405
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO160452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86750305Medicaid
COE23266Medicare UPIN
CO86750305Medicaid
COC807311Medicare PIN
COC438888Medicare PIN