Provider Demographics
NPI:1376529545
Name:LUYTEN, DYLAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:R
Last Name:LUYTEN
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:PO BOX 5788
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5788
Mailing Address - Country:US
Mailing Address - Phone:303-202-1280
Mailing Address - Fax:303-202-1281
Practice Address - Street 1:550 S WADSWORTH BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3111
Practice Address - Country:US
Practice Address - Phone:303-202-1280
Practice Address - Fax:303-202-1281
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40919207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19776853Medicaid
COH82381Medicare UPIN
COH82381Medicare UPIN