Provider Demographics
NPI:1437103835
Name:SOLSBERG, MURRAY (MD)
Entity Type:Individual
Prefix:
First Name:MURRAY
Middle Name:
Last Name:SOLSBERG
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 1:15 HUNTWICK LN
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-7111
Mailing Address - Country:US
Mailing Address - Phone:303-888-3396
Mailing Address - Fax:
Practice Address - Street 1:3601 S PEARL ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3805
Practice Address - Country:US
Practice Address - Phone:303-762-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO338332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200421930AMedicaid
CO300090895OtherRR MIC MCRE
COC810849OtherMEDICARE PTAN
WY110221400Medicaid
CO300090896OtherRR DIA MCRE
CO300090894OtherRR RIA MCRE
CO01338334Medicaid
MI104686356Medicaid
KS200421930AMedicaid
MI104686356Medicaid
CO01338334Medicaid
COCW5398Medicare PIN