Provider Demographics
NPI:1417907064
Name:GOLDSMITH, ALEX MARION (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:MARION
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4545 E 9TH AVE
Mailing Address - Street 2:#670
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3901
Mailing Address - Country:US
Mailing Address - Phone:303-320-7744
Mailing Address - Fax:303-388-2003
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:#670
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3901
Practice Address - Country:US
Practice Address - Phone:303-320-7744
Practice Address - Fax:303-388-2003
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35680207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01356807Medicaid
COG71458Medicare UPIN
CO01356807Medicaid