Provider Demographics
NPI:1376554741
Name:GRAUER, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:GRAUER
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 1:80 HEALTH PARK DR STE 270
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4644
Mailing Address - Country:US
Mailing Address - Phone:303-665-0286
Mailing Address - Fax:303-666-5112
Practice Address - Street 1:80 HEALTH PARK DR STE 270
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-4644
Practice Address - Country:US
Practice Address - Phone:303-665-0286
Practice Address - Fax:303-666-5112
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30848207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01308485Medicaid
COL3238Medicare ID - Type Unspecified
COE03476Medicare UPIN